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Mediators of Inflammation
Volume 2014 (2014), Article ID 172821, 7 pages
http://dx.doi.org/10.1155/2014/172821
Review Article

TNF Blocking Therapies and Immunomonitoring in Patients with Inflammatory Bowel Disease

1Département d'Hépatogastroentérologie, Hôpital Saint-Eloi, Centre Hospitalier Universitaire de Montpellier, 80 Avenue Augustin Fliche, 34295 Montpellier, France
2Département d’Immunologie, Hôpital Saint-Eloi, Centre Hospitalier Universitaire de Montpellier, 80 Avenue Augustin Fliche, 34295 Montpellier Cedex 5, France

Received 28 June 2013; Revised 15 January 2014; Accepted 17 February 2014; Published 18 March 2014

Academic Editor: Sophie Desplat-Jégo

Copyright © 2014 Romain Altwegg and Thierry Vincent. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Since their appearance in the armamentarium for inflammatory bowel disease (IBD) more than a decade ago, antitumor necrosis factor (TNF) inhibitors have demonstrated beneficial activity in induction and maintenance of clinical remission, mucosal healing, improvement in quality of life, and reduction in surgeries and hospitalizations. However, more than one-third of patients present primary resistance, and another one-third become resistant over time. One of the main factors associated with loss of response is the immunogenicity of anti-TNF biologics leading to the production of antidrug antibodies (ADAbs) accelerating their clearance. In this review we present the current state of the literature on the place of TNF and its blockage in the treatment of patients with IBD and discuss the usefulness of serum trough levels and ADAb monitoring in the optimization of anti-TNF therapies.