Post AntiTNF biologics

The most recent successfully-introduced medications for the treatment of Crohn's disease, infliximab and adalimumab, have targeted tumor necrosis factor (TNF). However, they are ineffective for some people, and become ineffective in others over time. The Lancet(free registration required) reports some of the different directions that researchers have been examining for further biologic agents, their safety and effectiveness in trials.

Investigators have long sought to identify a micro-organism that causes inflammatory bowel disease. The present theory suggests a breakdown in the balance
between putative species of protective versus harmful bacteria—a notion that has been termed dysbiosis.

Whilst many current drugs reduce the symptoms of Crohn's by suppressing the immune system, research is continuing into drugs that act as immune stimulators.

As a result of decades of intensive research, treatment for inflammatory bowel disease is undergoing a transition from the era of TNF antagonists to an era of novelbiological agents, including those that are able to stimulate the innate immune system.

As you might expect for a medical journal it's quite a technical article, but well worth the effort to see what possible treatments are just around the corner. For easier reading there's a summary at Medical News Today.