Forgotten drug interactions in IBD

A significant focus of chronic inflammatory bowel disease (IBD) treatment centers around the use of monoclonal antibodies that do not have any specific drug interactions. However, the data suggest that antibiotics and gut microbiota profiles can modulate the efficacy and immunogenicity of biotherapies. The selection of antibiotics during IBD treatment is therefore important. It is also suspected that proton pump inhibitors can impact the efficacy of biotherapies or the natural progression of IBDs. Other molecules, such as azathioprine, methotrexate, nonsteroidal anti-inflammatory drugs, and antibiotics, are regularly prescribed in the daily management of IBDs; their combination with each other, or with other molecules that appear to be harmless, can present a risk of drug interactions and sometimes severe toxicities. Finally, the arrival of small molecules, such as Janus Kinase (JAK) inhibitors, warrants better understanding of their characteristics and potential interactions, especially concerning cytochrome P450 modulators.