Anti-cytokine therapies, such as the three licensed anti-tumor necrosis factor-α (anti-TNF-α) antibodies, have transformed the management of difficult-to-treat IBD patients. However, only 40–50% of patients respond to these agents, there are side effects, and efficacy wanes with time. Consequently, great interest remains in new agents that may be more effective than anti-TNF-α antibodies. Here, we argue that no single agent will ever be clinically better than anti-TNF-α antibodies, and that there is no “Holy Grail” anti-cytokine biological therapy that will be clinically effective in all patients. Instead, work in this area should be focused on identifying new drugs targeting other cytokines (here, we concentrate on the interleukin-17 [IL-17] family and IL-21), which can be used logically in individual patients based on biomarker studies, as well as after failure of a first, second, or third biological treatment.
Inflamm Bowel Dis Monit 2010;10(4):111–6.