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The following is a summary of “Use of Immunomodulators, Biologic Therapies, and Small Molecules in Patients With Inflammatory Bowel Disease and Solid Organ Transplant,” published in the August 2024 issue of Gastroenterology by Ghusn et al.
Patients with inflammatory bowel diseases (IBDs) often require solid organ transplants (SOTs), leading to a higher prevalence of these procedures in this population.
Researchers conducted a retrospective study to utilize the effectiveness and safety of the combination of SOT-related immunosuppression and IBD medications in patients who underwent liver, kidney, or heart transplantation.
They searched PubMed, Scopus, MEDLINE, Embase, and Google Scholar databases. Patients with SOT were evaluated for the safety, effectiveness, and side effects of immunomodulators, biologic therapies, and small molecules. The evaluation included information from systematic reviews, meta-analyses, case series, and case reports.
The results demonstrate that there were 25 liver, 6 kidney, and 1 heart transplant studies involving patients with IBD. Common liver transplant immunosuppressants involved tacrolimus, mycophenolate mofetil, cyclosporine, and steroids. Anti-tumor necrosis factor (Anti-TNF) agents, widely used across all SOT types, demonstrated no significant safety issues despite observed infections and malignancies. Patients with liver transplants on tacrolimus positively responded to anti-integrins and ustekinumab without experiencing major complications. In the case of kidney transplants, the prevalent use of cyclosporine and tacrolimus, in combination with anti-TNF or ustekinumab, was safe, with rare reports of malignancy or infection.
Investigators concluded that anti-TNF, anti-integrin agents, and ustekinumab were generally safe in patients with solid organ transplants, but further research was required in specific subgroups.
Source: journals.lww.com/jcge/abstract/9900/the_use_of_immunomodulators,_biologic_therapies,.336.aspx
