Efficacy and safety of biological treatment in Crohn’s disease: our experience

Introduction: Crohn’s disease is chronic inflammatory bowel disease with still unknown aetiology. The aim of the treatment is to achieve remission and prevent complications such as fistulas, stenosis and abscesses. Biological therapy is introduced in cases of classical treatment failure and in fistulizing disease.

Aim: Evaluation the therapeutic efficacy and safety of biological therapy with monoclonal antibodies (infliximab or adalimumab) in Crohn’s disease treatment.

Material and methods : We evaluated the course of Crohn’s disease in 43 patients (27 men and 16 women) treated in the Department of Digestive Tract Diseases, Medical University of Lodz, who were qualified for biological treatment between 2008 and 2010. We analysed age and gender of patients, clinical symptoms, laboratory findings, efficacy and safety of treatment according to the Crohn’s Disease Activity Index (CDAI).

Results : In our examination 21 patients (48.8%) were treated with infliximab, 11 (25.6%) with adalimumab and in 11 cases (25.6%) therapy was conducted consecutively with both antibodies. The indication to substitute a therapeutic agent was lack of remission, loss of response during treatment or intolerance. As a result of biological treatment in 32 patients (74.4%) there was remission with average reduction of the CDAI indicator from 308 to 93.5 points. In 2 cases (4.7%) there was no clinical response. In 9 patients (20.9%) therapy was interrupted; two of them (4.7%) required urgent surgical intervention, in seven cases (16.3%) it was necessary because of treatment side effects. In the analysed period complications such as hypersensitivity to medication (7 patients), infections (3), insomnia (1), tuberculosis (1) or temporary vision disorders (1) were observed.

Conclusions : Biological therapy with the monoclonal antibodies infliximab or adalimumab appears to be effective and safe in inducing and maintaining clinical remission in Crohn’s disease.