[Risks of Cancer Associated with Therapeutic Drugs for Inflammatory Bowel Disease].

Won Moon, Jae Jun Park
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Abstract

Crohn's disease and ulcerative colitis are lifelong chronic inflammatory conditions, with many patients requiring ongoing immunomodulatory drug therapy for maintenance treatment. Recent therapeutic goals in inflammatory bowel disease (IBD) are not only aimed at symptomatic remission but also at achieving mucosal healing to improve the natural course of the disease. In this context, therapeutic approaches are being applied in clinical settings that involve early and appropriate use of drugs, such as immunomodulators or biologics, that have the potential to induce healing of the inflamed intestine before irreversible intestinal damage occurs. All drugs that continuously control intestinal inflammation in IBD can heal the mucosa and potentially reduce the incidence of colitis-associated bowel cancer; however, the continuous use of immunosuppressants can potentially increase the risk of malignancies. The safety issues of the drugs used in clinical practice are partly confirmed during their development processes or shortly after initial marketing, but in other cases, they are estimated through post-marketing case reports or epidemiological studies, sometimes decades after drug approval. This review explores the risks associated with malignancies related to the treatment of IBD, focusing on drugs currently approved in Republic of Korea.

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[与炎症性肠病治疗药物相关的恶性肿瘤风险]。
克罗恩病和溃疡性结肠炎是终生慢性炎症性疾病,许多患者需要持续接受免疫调节药物治疗以维持治疗。炎症性肠病(IBD)近期的治疗目标不仅是缓解症状,还要实现粘膜愈合,以改善疾病的自然病程。在这种情况下,临床上正在采用的治疗方法包括早期适当使用药物,如免疫调节剂或生物制剂,这些药物有可能在不可逆转的肠道损伤发生之前诱导发炎肠道的愈合。所有能持续控制 IBD 肠道炎症的药物都能使粘膜愈合,并有可能降低结肠炎相关肠癌的发病率;但持续使用免疫抑制剂有可能增加恶性肿瘤的风险。临床实践中使用的药物的安全性问题部分是在其开发过程中或首次上市后不久得到证实的,但在其他情况下,它们是通过上市后病例报告或流行病学研究估计出来的,有时甚至是在药物批准后几十年才得到证实。本综述探讨了与治疗 IBD 相关的恶性肿瘤风险,重点关注大韩民国目前批准的药物。
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