Seguridad en el diagnóstico y tratamiento de la enfermedad inflamatoria intestinal

The presentations at Digestive Disease Week 2013 emphasized treatment safety. Anti-tumor necrosis factor (TNF) agents and thiopurines are reasonably safe in breastfeeding and pregnancy. Several studies indicate that controlling the risk of tuberculosis when anti-TNF agents are planned presents several problems, both in the initial diagnosis of latent tuberculosis and in subsequent patient follow-up, given that cases of tuberculosis continue to occur, despite recommendations. Thiopurines increase the risk of lymphoma, but there is no residual risk when these drugs are withdrawn. Despite increasing knowledge of the risks and recommendations on how to avoid them, there remain considerable shortfalls in the application of preventive measures and, more specifically, in vaccinations. Infliximab and cyclosporin produce similar results when used to treat severe outbreaks of ulcerative colitis. Thromboembolism prevention continues to be deficient, and the barriers to effective prevention concern not only physicians but can also involve nursing staff, for example. There is still a wide margin for improvement in safety. New drugs under study (vedolizumab, golimumab) have not shown any hitherto unknown signs of significant toxicity.