Biologisk behandling av inflammatorisk tarmsykdom ved Aker universitetssykehus : effekt av TNF-alfa-hemmeren adalimumab

Abstract

The intention of this retrospective study is evaluation of the effect of the TNF á inhibitor adalimumab in patients with inflammatory bowel disease (IBD) treated at Aker University Hospital. The patient data were extracted from electronic patient charts. All patients with Crohn’s disease (CD) and ulcerative colitis (UC) treated with at least one injection of adalimumab, were included.

A total of 58 patients were included; 51 CD patients and 7 UC patients. In the CD group a reduction of CRP was observed, but this was not significantly altered (p=0,071). In the UC group significant changes of CRP were absent. In the CD group, significant alterations of calprotectin values were first observed after 6 months of treatment (p=0,001). There were no significant alterations of calprotectin values at any time in the UC group.

The Harvey Bradshaw Index, used in clinical evaluation of CD, was significantly reduced after 3 weeks of treatment with adalimumab (p<0,001). 76,5% of the patients in the CD group were satisfied with the treatment versus 57,1% of the patients in the UC group. No adverse events were observed.

The results suggest that the effect of adalimumab in treatment of IBD is uncertain. Adalimumab seems to be more efficient in patients with CD than in patients with UC. Additionally, it seems that at least 6 months of treatment is needed to achieve satisfactory effect. To clearly establish the effect of adalimumab, prospective studies comparing the intervention group with a control group, are needed.