Mexican consensus on the use of agents anti-TNF-alpha in the treatment of inflammatory bowel disease.

Inflammatory bowel disease is a chronic and relapsing disorder without any curative medical treatment. Different drugs have been focused to get clinical remission during the flare, maintenance of remission and improving the quality of life of inflammatory bowel disease patients. Recently, new therapeutic agents blocking the tumoral necrosis factor alpha, a pro-inflammatory cytokine have been approved for the use in these kind of patients. To establish the first Mexican Consensus for the use of anti tumoral necrosis factor alpha agents in the treatment of patients with inflammatory bowel disease. A group of gastroenterologist and colorectal surgeons from different regions of the country were invited to attend to this meeting. The consensus was divided in 7 sections and a total of 53 items were evaluated for all participants. The Delphi system was used in this consensus and several clinical trials were considered in order to provide recommendations according to evidence based medicine. Finally, conclusions were obtained after discussing all items. This is the first mexican Consensus that provides the recommendations about the use of anti tumoral necrosis factor alpha agents in inflammatory bowel disease patients It is important to have a deep knowledge about the anti tumoral necrosis factor alpha in the following conditions: indications and contraindications; parameters of clinical efficacy; predicting factors of medical treatment response; strategies for preventing and treating immunogenicity; efficacy and safety as well as the clinical factors for using these agents as first line of therapy (top-down).