在过去的几十年中，生物制剂已经彻底改变了克罗恩病和溃疡性结肠炎的治疗方法。尽管新型生物制剂不断涌现、炎症性肠病（IBD）的武器库不断扩大，但在世界大部分地区，抗肿瘤坏死因子（TNF）抗体仍是第一线生物制剂治疗方案。然而，抗TNF治疗并不对所有患者有效（一级非反应性），且患者可以随着时间的推移而失去效果（二级反应丧失）。本文概述了可用抗TNF抗体的当前引导和维持剂量方案以及成人患者IBD的相关挑战。我们概述了克服这些困难的不同策略，包括联合治疗，治疗药物监测（TDM）和剂量递增。最后，我们讨论了预期的抗TNF治疗的未来进展。抗TNF制剂将在未来十年内成为IBD治疗的支柱。将在预测反应和个体化剂量方案的生物标志物方面取得进展。皮下注射英夫利昔单抗的出现挑战了伴随性免疫抑制的需求。

During the last decades, biologics have revolutionized the treatment of Crohn´s disease and ulcerative colitis. Even though the inflammatory bowel disease (IBD) armamentarium is rapidly expanding with novel biologics, anti-tumor necrosis factor (TNF) antibodies remain the first-line biologic therapy in most areas of the world. However, anti-TNF therapy is not effective in all patients (primary non-response) and patients can lose effect over time (secondary loss of response).This review provides an overview of the current induction and maintenance dosing regimens of the available anti-TNF antibodies and associated challenges in adult patients with IBD. We outline different strategies to overcome these difficulties including combination therapy, therapeutic drug monitoring (TDM) and dose escalation. Finally, we discuss expected future progress in anti-TNF management.Anti-TNF agents will remain a cornerstone of IBD treatment in the coming decade. Progress will be made in biomarkers for the prediction of response and individualized dosing regimens. The advent of subcutaneous infliximab challenges the need for concomitant immunosuppression.