Remarkable advances have been made in the treatment of inflammatory bowel 
disease since the introduction of anti-tumor necrosis factor-α agents, 
especially for patients who are refractory to or cannot tolerate conventional 
therapies. Currently, infliximab, adalimumab, and golimumab are available in the 
East Asian medical market, and these agents have been shown to be effective for 
inducing and maintaining long-term remission of inflammatory bowel disease. 
Despite their clinical benefits, anti-tumor necrosis factor therapy can also 
lead to increased vulnerability to infections, development of autoimmune 
diseases and malignancy, and decreased immunogenicity of vaccinations. Because 
infectious diseases, such as tuberculosis, hepatitis, and influenza, remain 
major health problems in East Asia, more cautious use of biologics is needed. To 
further improve treatment efficacy and safety, close monitoring of inflammation, 
regular surveillance for malignancy, and regularly scheduled vaccinations are 
needed. Treatment strategies for biologics should be customized to meet the 
needs of different patients.