Biological Therapies for the Management of Enteric Disease: Considerations for the Clinician

Adam Saleh,1,2 Usman Ansari,2 Shaadi Abughazaleh,2 Kerri Glassner,2 Bincy P Abraham2 1Engineering Medicine, Texas A&M University, Houston, TX, USA; 2Department of Medicine – Division of Gastroenterology, Houston Methodist, Houston, TX, USACorrespondence: Bincy P Abraham, Department of Medicine – Division of Gastroenterology, Houston Methodist, 6550 Fannin St. Suite 1201, Houston, TX, 77030, USA, Tel +1-713-441-5042, Fax +1-713-797-0622, Email bpabraham@houstonmethodist.orgAbstract: Several biologic therapies have been approved for enteric diseases. We evaluate each biologic’s role based on their mechanism of action in treating these conditions. This review examines data on efficacy and safety, as well as considerations for using these therapies in clinical practice in inflammatory bowel diseases, enteric infections—specifically Clostridioides difficile colitis—and potentially in the increasingly prevalent disorder of eosinophilic esophagitis. When choosing an appropriate therapy, it is important to assess patient severity, as most biologics are approved for those with moderate to severe disease activity. With many years of data from clinical trials and real-world experience, these therapies have been shown to improve outcomes overall in enteric diseases, contributing to more options for our patients.Keywords: biologics, Crohn’s disease, ulcerative colitis, Clostridioides difficile colitis, microscopic colitis, enteric disease