**8. Anti-TNF-alpha agents**

Many reports confirmed the efficacy of anti-TNF-α antibody (infliximab/adalimumab) in the treatment of EB, where the remission rate can reach 80–89% [22–24]. There are also reports on the long-term efficacy of anti-TNF-α antibodies in treating EB [22]. Anti-TNF-α antibodies were also effective in preventing postoperative recurrence with a recurrence-free state for 2–3 years. Studies have reported that infliximab at 5 mg/kg is effective in improving ulcers and subsequently maintaining remission in patients with ulcers occurring at the anastomotic site within 2 weeks after ileoceocal resection who fail to respond to conventional therapy with prednisolone, azathioprine, mesalamine, and colchicine [25].

In a recent study, authors administered anti-TNF-α antibody to 49 patients with refractory EB and demonstrated its high efficacy based on both endoscopy results and a quantitative disease activity index, with a beneficial effect on sparing corticosteroids. Besides, anti-TNF-α antibodies demonstrated sufficient efficacy to control disease activity without concomitant corticosteroids in some patients [26].
