How and when should biosimilars be used to treat patients with inflammatory bowel disease (IBD)? With more than 10 infliximab and adalimumab biosimilars now available in the United States for the treatment of IBD and even more in the pipeline, this question is increasingly being encountered in clinical practice. In a review article in this month’s issue of Gastroenterology & Hepatology, Dr Shubha Bhat and Dr Sunanda V. Kane present a practical and comprehensive roadmap on the use of biosimilars in patients who have IBD. The authors provide helpful background on concepts and considerations involving biosimilars and review the different biosimilars currently available on the US market. Additionally, the authors discuss strategies for navigating biosimilar use in a number of common clinical scenarios, such as starting a biosimilar in a patient naive to biologics, first-time switching of a reference product to a biosimilar, and biosimilar-to-biosimilar switching.
Our coverage of IBD treatment continues with our Advances in IBD column, which looks at the use of sphingosine-1 phosphate (S1P) receptor modulators. Dr Bruce E. Sands discusses study designs and data involving ozanimod and etrasimod, the 2 S1P receptor modulators that are currently approved for the treatment of ulcerative colitis, and which patients respond best to this class of medications. Along with other topics, he also discusses the safety of these agents, their positioning in the expanding armamentarium of ulcerative colitis therapies, and considerations to keep in mind when choosing a treatment.
This issue also features two columns involving liver diseases. Our Advances in Hepatology column, authored by Dr Brian P. Lee, focuses on the treatment of patients with alcohol-associated hepatitis. His discussion includes the new nomenclature for metabolic dysfunction-associated steatotic liver disease with increased alcohol consumption, selection of patients with alcohol-associated hepatitis for early liver transplant, and research on outcomes in this patient population. Our HCC in Focus column provides an overview of current surveillance, staging, and treatment for hepatocellular carcinoma (HCC). Dr Sheila Eswaran reviews recent updates in these areas, such as the PAGE-B score, abbreviated magnetic resonance imaging, the understanding of intermediate-stage cancers, and recent advances in systemic and nonsystemic therapies for HCC.
Proton pump inhibitors (PPIs) are the focus of our Advances in GERD column, which is authored by Dr Paul Moayyedi. He takes a look at the safety and potential concerns of PPI therapy, why there have been conflicting findings about potential risks of PPIs, and which adverse events said to be associated with PPI therapy are true and which are not, among other issues.
Finally, in our Case Study Series section, Dr Nitin K. Ahuja presents a patient who has irritable bowel syndrome with constipation (IBS-C). Topics of discussion include how the patient’s presentation led to an IBS-C diagnosis, the burden of abdominal and bowel symptoms in patients who have IBS-C, the assessment of symptom control, and the efficacy of various medications (both those over the counter and those approved by the US Food and Drug Administration) for relieving constipation and abdominal pain.
I hope that this issue provides valuable insights for your clinical practice.
Sincerely,
Gary R. Lichtenstein, MD, AGAF, FACP, FACG