What should be done in patients with inflammatory bowel diseases those lose a response to biological therapy?

Abstract

Biological therapy became an important component of conservative therapy for patients with moderate or severe inflammatory bowel disease (IBD) at the beginning of this century. Primary failure in biological therapy is relatively rare and was described in clinical practice for 10% of IBD patients. From the clinical point of view, secondary failure is more frequent and occurs in 15-20% of patients during one year of therapy. Crucial questions which should be addressed prior to the intensification or withdrawal of biological therapy include confirmation of the presence of an inflammation, IBD complications and, primarily, opportunistic infections. Intensification of biological therapy is effective in 2/3 of IBD patients, who enjoy long-term benefits following such treatment. It is significant that half of patients are subsequently able to return to their original therapeutic strategy.