eISSN: 1897-4317
ISSN: 1895-5770
Gastroenterology Review/Przegląd Gastroenterologiczny
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2/2020
vol. 15
 
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abstract:
Original paper

Efficiency and safety of one-year anti-TNF-α treatment in Crohn’s disease: a Polish single-centre experience

Marcin Sochal
1, 2
,
Monika Krzywdzińska
1
,
Agata Gabryelska
1, 2
,
Renata Talar-Wojnarowska
1
,
Ewa Małecka-Panas
1

  1. Department of Digestive Tract Diseases, Medical University of Lodz, Lodz, Poland
  2. Department of Sleep Medicine and Metabolic Disorders, Medical University of Lodz, Lodz, Poland Gastroenterology Rev
Gastroenterology Rev 2020; 15 (2): 156–160
DOI: https://doi.org/10.5114/pg.2019.90079
Online publish date: 2019/12/01
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Introduction
Anti-TNF- therapy of Crohn’s disease (CD) represents considerable progress in inflammatory bowel disease (IBD) treatment; however, many patients still require surgical intervention. The Polish National Insurance Fund currently only covers up to 2 years of infliximab (IFX) therapy in CD patients and 1 year of adalimumab (ADA).

Aim
To estimate the effectiveness and side effects of the anti-TNF- Polish therapeutic program in CD patients.

Material and methods
In this retrospective study, medical documentation of 80 CD patients treated with anti-TNF- (IFX or ADA) was analysed. Fifty-two patients finished 1 year of therapy, and 28 individuals did not complete it due to lack of response to treatment or severe side effects.

Results
After treatment, 27 (67.50%) patients achieved a semi-annual remission and 14 (35%) achieved yearly remission. Twenty percent of patients experienced severe side effects such as anaphylactic shock, pneumonia, shingles, or upper respiratory tract infections. A strong negative correlation between the number of patients in remission and the period since therapy termination (r = –0.996, p < 0.001) was found. During the 1-year follow-up, 20 patients were re-enrolled in the biological therapy program (the median time to next therapy was 231 days IQR: 126.5–300.5)

Conclusions
Anti-TNF- treatment in CD is relatively safe. The restricted time period of the therapy affects the clinical course of the disease and entails the need to resume biological therapy.

keywords:

Crohn’s disease, infliximab, adalimumab, effectiveness of biological treatment, side effects
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