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Review
. 2021 Apr;70(4):796-802.
doi: 10.1136/gutjnl-2020-322129. Epub 2020 Aug 26.

Emerging treatment options for extraintestinal manifestations in IBD

Thomas Greuter  1   2 , Florian Rieder  3 , Torsten Kucharzik  4 , Laurent Peyrin-Biroulet  5 , Alain M Schoepfer  6   7 , David T Rubin  8 , Stephan R Vavricka  1   9
Affiliations
Review

Emerging treatment options for extraintestinal manifestations in IBD

Thomas Greuter et al. Gut. 2021 Apr.

Abstract

Extraintestinal manifestations (EIMs) are frequently observed in IBDs and contribute considerably to morbidity and mortality. They have long been considered a difficult to treat entity due to limited therapy options, but the increasing use of anti-tumour necrosis factors has dramatically changed the therapeutic approach to EIM in recent years. Newly emerging therapies such as JAK inhibitors and anti-interleukin 12/23 will further shape the available armamentarium. Clinicians dealing with EIMs in everyday IBD practice may be puzzled by the numerous available biological agents and small molecules, their efficacy for EIMs and their potential off-label indications. Current guidelines on EIMs in IBD do not include treatment algorithms to help practitioners in the treatment decision-making process. Herein, we summarise knowledge on emerging biological treatment options and small molecules for EIMs, highlight current research gaps, provide therapeutic algorithms for EIM management and shed light on future strategies in the context of IBD-related EIMs.

Keywords: IBD clinical; TNF; arthritis.

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Conflict of interest statement

Competing interests: TG has a consulting contract with Sanofi-Aventis, received a travel grant from Falk Pharma and Vifor, and an unrestricted research grant from Novartis. SRV received consultant fees and unrestricted research grants from Abbott, Celtrion, Ferring, MSD, Pfizer, Sanofi-Aventis, Takeda, Tillots, UCB, Vifor and Falk Pharma. FR has consulted with Allergan, AbbVie, Boehringer-Ingelheim, Celgene, Helmsley, Jannsen, Pliant, Receptos, RedX, Roche, Samsung, Takeda, Thetis, UCB and received research grants from Celgene, Pliant and UCB. TK received consultant fees and speaker honoraria from Abbott, Amgen, Biogen, Celtrion, Falk Pharma, Janssen, MSD, Takeda and UCB. LP-B reports personal fees from Merck, Abbvie, Janssen, Ferring, Tillots, Celltrion, Takeda, Pfizer, Amgen, Biogen, Samsung Bioepis, Genentech, Vifor, Pharmacosmos, Biogaran, Boerhinger-Ingelheim, Lilly, Index Pharmaceuticals, Sandoz, Celgene, Alma, Sterna, Nestlé and Enterome. AMS received consulting and/or speaker fees from Abbvie, Adare, Dr Falk Pharma, MSD, UCB, Pfizer, Takeda, Vifor, Receptos, Regeneron and received research grants Adare, Dr Falk Pharma, Receptos and Regeneron. No company representative was involved in conception, writing or financing of this study.

Figures

Figure 1
Figure 1
Overview of the most common EIM and their biological, small-molecule treatment options. EIM, extraintestinal manifestation; IL, interleukin; JAK, Januskinase; TNF, tumour necrosis factor; Vedo, vedolizumab.
See this image and copyright information in PMC

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