Biologic therapy in Crohn's disease: state of the art.

PURPOSE OF REVIEW: This review is intended to appraise the evolution and latest developments in treatment strategies and management of patients with Crohn's disease.

RECENT FINDINGS: The last 24 months has further established the role of anti-tumor necrosis factor therapy in Crohn's disease with two new agents demonstrating efficacy in well designed randomized controlled trials. Furthermore, other important strategies have been identified including inhibition of leukocyte trafficking and blocking of interleukin-12 and 23. Along with the evolution in drug therapies there has been more extensive investigation on the best means to use these new agents.

SUMMARY: Biologic therapy has changed and will continue to transform the way we treat patients with Crohn's disease. Treatment success has been redefined. The challenges will be to utilize these agents in the best algorithms possible to benefit not only short-term but also long-term outcomes.