Sammendrag
The aim of this study is to evaluate the effect of tumour necrosis factor alpha (TNF-á) antibody treatment for patients with inflammatory bowel disease (IBD). 108 consecutive patients with IBD (19 with ulcerative colitis (UC) and 89 with Crohn’s disease (CD)) treated with infusions of infliximab at Aker University Hospital were included. Treatment regimes were either “on demand” infusions or maintenance therapy. Response to treatment has been evaluated on the basis of endoscopic findings and biopsies, laboratory values and clinical evaluation of patient condition. Additionally, all adverse events have been described.
Based on clinical evaluation, 10 patients with UC (53%) experienced good response, 4 (21%) had some response while 5 patients (26%) did not respond. For CD the corresponding numbers were 60 (67%), 15 (17%) and 14 (16%). Mean change in CRP from 0 to 2 weeks was -14,3 (p=0,024) (UC) and -18,9 (p<0,001) (CD). Calprotectin values were classified into groups containing normal, slightly elevated, moderately elevated and severely elevated values. This classification yielded for UC at 0 weeks 0, 0, 3 and 13 patients in corresponding groups, and at 6 months 3, 1, 2 and 2 (p=0,024). Correspondingly for CD; at 0 weeks 0, 5, 22, 38 and at 6 months 10, 12, 11 and 13 (p<0,001). 20 patients (19%) experienced adverse events possibly related to infliximab treatment.
Based on this study, infliximab is an effective treatment for moderate to severe IBD. Patients generally tolerate the treatment well with few severe adverse reactions.