Abstract
The therapy of inflammatory bowel diseases (IBD) has substantially changed over the past two decades, mostly because of the introduction of biologic agents. Whereas aminosalicylates still remain the major drug for ulcerative colitis, their role in Crohn's disease has however become negligible.
Thiopurines dominate in long-term maintenance therapy of IBD, especially in Cronh's desease; they also play an important role in combined therapy with anti-TNF antibodies. Systemic steroids still remain an important and highly effective drug for severely active IBD.
Budesonide is a clearly weaker, topical variant with no effect in maintenance therapy. Whereas biologic therapy, namely anti-TNF antibodies, are currently at the top of the therapeutic pyramid, vedolizumab, a promising representative of the new class of integrin antibodies has recently been registered, and is expected to be marketed soon in the Czech Republic.
Surgical therapy is an inseparable part of IBD treatment. Current management of IBD is based on individualized and tailored therapy, and aimed at treatment that targets: the elimination of the risk of irreversible structural changes and repeated surgeries with disabling consequences for the patient.