Place of immunosuppressants in chronic inflammatory bowel diseases

Immunosuppressants, such as azathioprine, methotrexate and cyclosporine, play a vital role in the management of chronic inflammatory bowel diseases. Predominant before the emergence of anti-TNF alpha biotherapies (2000s), they remain important, particularly in combination with these new treatments to optimize clinical outcomes. The aim of this work is to explore the role and importance of immunosuppressants in the treatment of chronic inflammatory bowel diseases such as Crohn's disease and ulcerative colitis. This is a descriptive analysis highlighting how immunosuppressants act at the immune level to reduce inflammation and improve symptoms in patients with IBD. After discussing the risks and adverse effects associated with the use of immunosuppressants, as well as strategies to minimize these effects, the need to individualize treatment to each patient (clinical situation, response to treatment, potential side effects) is highlighted. The benefits must be carefully weighed regarding the potential risks, requiring careful monitoring throughout the treatment.