Clinical and biochemical response of treatment with anti-TNFα in Egyptian IBD patients: Zagazig University IBD Clinic experience

Abstract

The aim is to evaluate the clinical and biochemical response of treatment with anti-tumor necrosis factorα (anti-TNFα) therapy used for induction and maintenance of remission in Egyptian inflammatory bowel disease (IBD) patients who attended an IBD Clinic of the Internal Medicine Department, Zagazig University over a one year. Methods A prospective cohort study included seventy-seven IBD patients; 40 ulcerative colitis (UC) and 37 Crohn’s disease (CD) indicated for biological therapy. Patients were randomly assigned into either two treatment subgroups: (a) received Infliximab, or (b) received Adalimumab. Results 51.95% (n=40/77) showed an initial significant improvement following induction of remission dose and completed the study. Clinical remission was maintained to week 52 in 37 patients. The reduction rate of fecal calprotectin from the baseline was higher for CD compared to UC patients (82.4% and 51.7%, respectively, p < 0.001 for both). 14.29% of all patients were non-responders; 10.39% were referred for surgery, 15.59% discontinued treatment due to adverse effects, mostly infusion reactions as an anaphylactic reaction or late serum sickness-like symptoms. Conclusion anti-TNFα therapy seems to deliver a beneficial clinical and laboratory response in severe, steroid-dependent, or refractory patients. The effect was more noticed CD than UC patients; however, longer follow-up periods and mucosal healing assessment are needed in further studies for our populations.