Biological agents for inflammatory bowel diseases (IBD) targeting tumor necrosis 
factor (TNF) have changed the way to treat IBD refractory to standard 
medications and allowed us to reach new therapeutic goals such as mucosal 
healing and deep remission. A better understanding of the components of the 
pathological processes that are a hallmark of IBD has led to the development of 
a new family of biological agents in Crohn's disease and ulcerative colitis. 
Biosimilars, which are copy versions of currently licensed biological agents, 
will be soon available. The biosimilar of infliximab is as effective and as safe 
as its originator in rheumatologic conditions, while a new anti-TNF agent, 
namely golimumab, has been recently approved for refractory ulcerative colitis. 
Beyond TNF blockers, anti-adhesion molecules appear to be a potent drug class 
for IBD. Vedolizumab was recently approved for both Crohn's disease and 
ulcerative colitis. Numerous other compounds are in the pipeline. Ustekinumab 
looks very promising for Crohn's disease. Smad7 antisense oligonucleotide might 
enrich our armamentarium if preliminary data are confirmed in upcoming clinical 
trials. Herein, we review the efficacy and safety of new and emerging biological 
agents that are currently investigated in IBD clinical trials.