Non-biological therapy in inflammatory bowel disease-old and new evidence

The medical therapy for inflammatory bowel disease has changed during recent years because of new molecular pathogenetic findings and the consequent development of more specific agents, such as biologicals. The principal goal of treatment aims to modify the natural course of these chronic progressive diseases in high-risk patients. However, 'non-biological' therapies still maintain a fundamental role because of their validated efficacy in several clinical settings. In a comprehensive review, the most important concept remains that therapy should be personalised for each patient, evaluating the risks and benefits of all therapeutic approaches in the specific clinical context. In this review, the effectiveness of steroids, mesalazine, antibiotics and immunosuppressive agents is evaluated on the basis of old and new evidence, along with a summary of the recommendations of the corresponding international guidelines. © Touch Briefings 2012.