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Doença inflamatória intestinal : modelos animais para o seu estudo e estratégias farmacológicas para a sua terapêutica
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A Doença Inflamatória Intestinal compreende duas patologias inflamatórias, crónicas e recidivantes: a Doença de Crohn e a Colite Ulcerosa.
Nos últimos anos verificou-se um aumento do número de casos diagnosticados de Doença Inflamatória Intestinal, que tem sido acompanhado por enormes progressos a nível da investigação da sua fisiopatologia e pelo desenvolvimento de diversos fármacos direcionados a componentes específicos da cadeia inflamatória, com recurso a modelos animais experimentais.
As terapêuticas clássicas, baseadas nos aminossalicilatos, corticosteróides, antibióticos e imunossupressores, estão longe de responder a todas as necessidades dos doentes. A introdução das terapêuticas biológicas permitiu melhorar significativamente a qualidade de vida dos pacientes com Doença Inflamatória Intestinal moderada a severa. Destas novas terapias, quatro fármacos encontram-se aprovados no tratamento da Doença Inflamatória Intestinal pela Food and Drugs Administration: Infliximab, Adalimumab, Certolizumab pegol (agentes anti-TNFα) e Natalizumab (agente anti-integrina α4). A nível europeu, apenas o Infliximab e o Adalimumab encontram-se aprovados. Adicionalmente, diversos agentes biológicos têm evidenciado resultados promissores (Vedolizumab, Ustekinumab e Tocilizumab).
A Doença Inflamatória Intestinal, por ser uma doença crónica e que requer um tratamento continuado, a intervenção do farmacêutico é fulcral no aconselhamento sobre o uso racional dos fármacos e na sensibilização dos doentes acerca da importância da adesão à terapêutica, que compromete a eficácia do tratamento prescrito.
Nesta monografia é feita uma revisão bibliográfica da terapêutica atual da Doença Inflamatória Intestinal, as perspetivas de tratamento futuras, os modelos animais experimentais com maior relevância no estudo desta doença e a importância do farmacêutico no seguimento destes doentes.
Inflammatory bowel disease comprises two inflammatory, chronic and relapsing pathologies: Crohn’s disease and Ulcerative colitis. In the last few years, there has been an increase in the number of inflammatory bowel disease diagnoses, accompanied by an enormous progress in the investigation of its physiopathology and by the development of several drugs targeted at specific components of inflammatory chain, using experimental animal models. The classic therapies, based on aminosalicylates, corticosteroids, antibiotics and immunosuppressives are far from answering all of patient’s needs. The introduction of biological therapies allowed to significantly improve the quality of life of patients with moderate to severe inflammatory bowel disease. Four of these new drugs are currently approved by the Food and Drugs Administration: Infliximab, Adalimumab, Certolizumab pegol (anti-TNFα agents) and Natalizumab (anti- α4 Integrin agent). In Europe, only Infliximab and Adalimumab are currently approved for this purpose. Additionally, several other biological agents have demonstrated promising results (Vedolizumab, Ustekinumab and Tocilizumab). As a chronic condition, inflammatory bowel disease needs chronic treatment. The pharmacist’s intervention is crucial in advising the patient on the correct use of drugs and increasing their awareness of the importance of adhering to the prescribed therapy, in order to optimize its efficacy. This paper/monography will provide a literature review of the following topics: current therapies for inflammatory bowel disease, prospects for future treatments, the most relevant experimental animal models for the study of this disease and the role of the pharmacist in monitoring these patients.
Inflammatory bowel disease comprises two inflammatory, chronic and relapsing pathologies: Crohn’s disease and Ulcerative colitis. In the last few years, there has been an increase in the number of inflammatory bowel disease diagnoses, accompanied by an enormous progress in the investigation of its physiopathology and by the development of several drugs targeted at specific components of inflammatory chain, using experimental animal models. The classic therapies, based on aminosalicylates, corticosteroids, antibiotics and immunosuppressives are far from answering all of patient’s needs. The introduction of biological therapies allowed to significantly improve the quality of life of patients with moderate to severe inflammatory bowel disease. Four of these new drugs are currently approved by the Food and Drugs Administration: Infliximab, Adalimumab, Certolizumab pegol (anti-TNFα agents) and Natalizumab (anti- α4 Integrin agent). In Europe, only Infliximab and Adalimumab are currently approved for this purpose. Additionally, several other biological agents have demonstrated promising results (Vedolizumab, Ustekinumab and Tocilizumab). As a chronic condition, inflammatory bowel disease needs chronic treatment. The pharmacist’s intervention is crucial in advising the patient on the correct use of drugs and increasing their awareness of the importance of adhering to the prescribed therapy, in order to optimize its efficacy. This paper/monography will provide a literature review of the following topics: current therapies for inflammatory bowel disease, prospects for future treatments, the most relevant experimental animal models for the study of this disease and the role of the pharmacist in monitoring these patients.
Descrição
Trabalho Final de Mestrado Integrado, Ciências Farmacêuticas, Universidade de Lisboa, Faculdade de Farmácia, 2014
Palavras-chave
Doença Inflamatória Intestinal Doença de Crohn Colite ulcerosa Modelos animais Estratégias farmacológicas Futuras terapias Mestrado Integrado - 2014