Intestinal Inflammation: Biologics and Small Molecules

The therapeutic approaches in treating the immune-mediated diseases, such as chronic idiopathic intestinal inflammation in inflammatory bowel disease encompass a variety of conventional anti-inflammatory medicines and newly designed biological medicines and small molecules, as well. The therapeutic protocols are not effective in all patients and in all phenotypes of disease, across the different cohorts of patients and different stages of the disease. Unlike conventional anti-inflammatory drugs, such as corticosteroids and/or immunosuppressives that act on a whole human body system, biological medicines, and newly synthetized small molecules are directed to block specific pro-inflammatory cytokines, integrins, or signaling pathways and hubs. The sequential and combined nature of proposed regimens of anti-inflammatory therapy, along with dose escalation and/or shortening the intervals between the doses and proven immunogenicity of certain biologicals and their biosimilars pave the scenery of medical decisions and possibilities to encounter various drug interactions more complicated. In this chapter, the authors brought up the most significant drug interactions, involving biologicals and newly designed small molecules in treating intestinal inflammation with focus on medicines that are already in wide clinical use for treating the intestinal inflammation. The text of this chapter is complementary to the text of chapters dealing with anti-inflammatory drugs (Sect. 9 in Part 2 of this book) and drug interactions of conventional anti-inflammatory drugs (Chap. 28 in Part 5 of this book).