Comparative effectiveness and safety of steroids, Aminosalicylates, and biological drugs in patients with inflammatory bowel diseases
Authors
1 Tropical Medicine Department, Faculty of Medicine - Menoufia University - Shebin Elkom- Menoufia, Egypt
2 Pathology department Faculty of Medicine, Menoufia University, Egypt.
3 EL-Maadi Medical complex ,Military hospital ,Egypt
Abstract
Background: Crohn's disease and ulcerative colitis are forms of inflammatory bowel disease (IBD). Several drugs aimed at controlling intestinal inflammation have been developed.
Aim of the study: To compare the effectiveness and safety of Steroids, 5’ASA, Infliximab, and Adalimumab in patients with Ulcerative colitis (UC) or Crohn’s disease (CD).
Patients and methods: A multicenter cross-sectional study was conducted among 174 patients with IBD. Patients were classified into four groups according to treatment regimen.
Results: 50 patients (28.7%) with CD and 124 (71.3%) with UC, 46 patients (26.4%) showed lesions confined to the recto-sigmoid area, 38 patients (21.8%) with left-sided lesions, 53(29.5%) with pancolitis, and 37(21.3%) with ileal or Small intestinal involvement. 50(28.7%) patients with mild activity, 86(49.7%) with moderate activity and 38(21.8%) with severe activity. There was a statistically significant difference in pre- and post-Mayo treatment scores for UC (P=0.06 and 0.002, respectively). In CD, there was a statistically significant difference in pre- and post-treatment Crohn’s disease activity index (CDAI), degree, and percent change (P=0.005, 0.003, 0.002, 0.0006, respectively). Primary drug-non response and relapse were more pronounced in Group (I ), 55%and 62.1%, and 0% and 9%, respectively, in Group (IV) (P<0.001). At the same time, drug-induced complications were more common in Group (II) than in the other groups (P<0.001). Moreover, failure to achieve remission was more common in Groups II and III (14.3% and 15.4%, respectively; P<0.001), and financial intolerance predominated in Groups III and IV (36.5% and 54.5%, respectively). In CD, fistula obliteration and resection-anastomosis in UC were recorded in Groups I, II, and III, but no statistically significant difference in surgical need was observed (P=0.7 and 0.3, respectively).
Conclusion: Biological drugs use in IBD seems to be more effective and safer, with less need for surgical intervention and hospitalization than conventional treatments.
Aim of the study: To compare the effectiveness and safety of Steroids, 5’ASA, Infliximab, and Adalimumab in patients with Ulcerative colitis (UC) or Crohn’s disease (CD).
Patients and methods: A multicenter cross-sectional study was conducted among 174 patients with IBD. Patients were classified into four groups according to treatment regimen.
Results: 50 patients (28.7%) with CD and 124 (71.3%) with UC, 46 patients (26.4%) showed lesions confined to the recto-sigmoid area, 38 patients (21.8%) with left-sided lesions, 53(29.5%) with pancolitis, and 37(21.3%) with ileal or Small intestinal involvement. 50(28.7%) patients with mild activity, 86(49.7%) with moderate activity and 38(21.8%) with severe activity. There was a statistically significant difference in pre- and post-Mayo treatment scores for UC (P=0.06 and 0.002, respectively). In CD, there was a statistically significant difference in pre- and post-treatment Crohn’s disease activity index (CDAI), degree, and percent change (P=0.005, 0.003, 0.002, 0.0006, respectively). Primary drug-non response and relapse were more pronounced in Group (I ), 55%and 62.1%, and 0% and 9%, respectively, in Group (IV) (P<0.001). At the same time, drug-induced complications were more common in Group (II) than in the other groups (P<0.001). Moreover, failure to achieve remission was more common in Groups II and III (14.3% and 15.4%, respectively; P<0.001), and financial intolerance predominated in Groups III and IV (36.5% and 54.5%, respectively). In CD, fistula obliteration and resection-anastomosis in UC were recorded in Groups I, II, and III, but no statistically significant difference in surgical need was observed (P=0.7 and 0.3, respectively).
Conclusion: Biological drugs use in IBD seems to be more effective and safer, with less need for surgical intervention and hospitalization than conventional treatments.
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