Table 1.
Treatment type | Related drugs | Mechanism of action | Features | Potentials adverse effects | References |
---|---|---|---|---|---|
Aminosalicylates | Mesalamine Olsalazine Balsalazide Sulfasalazine |
Inhibition of IL-1, TNF-α, and platelet activating factor (PAF), decreased antibody secretion. | Locally immunosuppressive, nonspecific inhibition of cytokines; medium cost. | Headache, dizziness, dyspepsia, epigastric pain, abdominal pain, nausea, vomiting, and diarrhea. | [38–41] |
| |||||
Immunomodulators | Azathioprin 6-mercaptopurin Methotrexate |
Blockage of de novo pathway of purine synthesis. | Antiproliferative effects, reduction of inflammation. | Black, tarry stools, bleeding gums, chest pain, fever, chills, swollen glands, pain, cough, and weakness. | [42–48] |
| |||||
Corticosteroids | Prednisone Methylprednisolone Hydrocortisone Budesonide |
Blockage of phospholipase A2 in the arachidonic acid cascade altering the balance between prostaglandins and leukotrienes; stimulation of apoptosis of lamina propria lymphocytes; suppression of the transcription of cytokines. | High immunosuppression, risk of potential infections, adverse effects with long periods of use, low cost. | Full moon face, difficulty of healing, acne, sleep and mood disturbances, glucose intolerance, osteoporosis, osteonecrosis, subcapsular cataracts, myopathy, infections, acute adrenal insufficiency, myalgia, malaise, arthralgia or intracranial hypertension, and pseudorreumatism syndrome. | [49, 50] |
| |||||
Biologicals: anti- cytokine drugs | Infliximab Adalimumab Certolizumab-pegol Golimumab Ustekinumab (phase 3 trial) |
Induction of apoptosis in proinflammatory cells; binding specifically to TNF-α, blockage of the interaction the receptor. | Specific inhibition of cytokine, immunosuppression, high cost, advanced technology required. | Abdominal or stomach pain, chest pain, chills, cough, dizziness, fainting, headache, itching, muscle pain, nasal congestion, nausea, sneezing, weakness, vomiting, bloody urine, cracks in the skin, diarrhea, pain, fever, abscess, back or side pain, bone or joint pain, constipation, falls, facial edema, general feeling of illness, hernia, irregular heartbeat, unusual bleeding, weight loss, increased risk of reactivation of latent tuberculosis, and increased risk for developing infections and lymphoma. | [24, 51–73] |
| |||||
Biologicals: anti-cell adhesion molecule | Vedolizumab Natalizumab |
Inhibition of migration. | Specific inhibition of cell adhesion molecules high cost, advanced technology required. | Nasopharyngitis, headache and abdominal pain, increased risk of infections, serious infections, and progressive multifocal leukoencephalopathy (natalizumab). | [63, 74–79] |