The introduction of infliximab into clinical practice is one of the most 
significant advances in the care of patients who have IBD. Infliximab has become 
an important part of the medical armamentarium to treat extraintestinal 
manifestations that often are refractory to other medications and are a 
significant cause of morbidity in these patients. Two other TNF inhibitors 
recently have demonstrated efficacy in CD: certolizumab pegol and adalimumab. 
The Food and Drug Administration has approved adalimumab for use in RA. One 
predicts that these agents also may have activity in the extraintestinal 
manifestation for IBD. To determine whether future biologics are effective in 
the EIM of IBD, one may need to look no further than the vast clinical trial 
experience in primary chronic inflammatory diseases of the joints and skin: RA 
and psoriasis. For example, the Food and DRug Administration recently has 
approved an anti-B-cell therapy, rituximab, and a T-cell costimulation 
modulator, abatacept, for use in RA. It certainly will be of interest to 
determine whether these biologic agents demonstrate efficacy in the intestinal 
and EIM of IBD.