The development of tumour necrosis factor a (TNF-α) blocking biologics for the treatment of Crohns disease represents a major step forward in the ability to treat it. A variety of TNF-a antagonists have been used to inhibit TNF-α in patients

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TNF-? blockade as a new effective treatment for Crohn's disease

Introduction

Crohn's disease (CD) is a chronic inflammatory disorder of the gastro-intestinal tract of unknown aetiology. The disease most commonly affects the terminal ileum and the ileocaecal region. Clinical symptoms include diarrhoea accompanied by blood, abdominal pain and weight loss. Obstruction, fistula formation and perianal disease are the most common complications (1, 2, 3).

Pharmacologic treatment of CD is aimed at reducing inflammation during relapse and maintaining remission. Therapy can be initiated with a combination of 5-aminosalicylates, immunosuppressive drugs and corticosteroids. However, significant proportion of patients with moderate to severe CD develops resistance to corticosteroids and immunosuppressive drugs (1, 4).

The development of tumour necrosis factor ? (TNF-?) blocking biologics for the treatment of Crohn's disease represents a major step forward in the ability to treat it. A variety of TNF-? antagonists have been used to inhibit TNF-? in patients with CD, including the mouse/human chimeric monoclonal antibody (infliximab), the humanized monoclonal antibody CDP571, the human soluble TNF-? p55 receptor (onercept), the human monoclonal antibody (adalimumab) and the p75 soluble TNF receptor fusion protein (etanercept) (2, 5, 6).

The only one TNF-? inhibitor currently