The retrospective evaluation of response to adalimumab and infliximab treatment in patients diagnosed with inflammatory bowel disease

Inflammatory bowel disease encompasses two major forms, known as Crohn's disease and ulcerative colitis. The Crohn's Disease Activity Index is used to determine the severity of disease activity in patients with Crohn's disease. On the other hand, the Truelove-Witts activity index is used to determine the severity of disease activity in patients with ulcerative colitis. Adalimumab and infliximab are biological agents used in the treatment of patients with inflammatory bowel disease. The aim of this study is to conduct a retrospective evaluation regarding the response to adalimumab and infliximab treatment in patients with inflammatory bowel disease. The data of the patients who was over the age of 18, diagnosed with inflammatory bowel disease, and followed up in Gastroenterology Clinic and Outpatient Clinic of Firat University Hospital between January 2008-April 2019 were assessed. Eighty patients who received adalimumab and infliximab treatment regularly for at least 4 weeks were included in the study. Leukocyte, erythrocyte sedimentation rate, C-reactive protein and neutrophil / lymphocyte ratio, which are the parameters related to the activity of the disease, were compared prior to and after treatment in order to evaluate the response to adalimumab and infliximab treatment. Hemoglobin levels of the patients prior to and after treatment were also compared. Erythrocyte sedimentation rate, C-reactive protein, leukocyte and neutrophil / lymphocyte ratio levels; which was used in the evaluation of ulcerative colitis and Crohn's disease activity, were found significantly lower in patients after adalimumab and infliximab treatment when compared to pre-treatment levels (p <0.05). When the hemoglobin levels of the patients with ulcerative colitis and Crohn's disease were analyzed, it was found that patients who received adalimumab and infliximab treatment had significantly higher levels of hemoglobin after the treatment when compared to the hemoglobin levels prior to the treatment (p <0.05). Moreover, the Crohn's Disease Activity Index of patients who were diagnosed with Crohn's disease, and received adalimumab and infliximab treatment were compared, and it was found that it was significantly lower after the treatment (p <0.05). Truelove and Witts Activity Index of patients who were diagnosed with Crohn's disease, and received adalimumab and infliximab treatment were compared prior to and after the treatment, and it was found that it was significantly lower after the treatment (p <0.05). The results showed that the recovery rate was %83,3 in crohn's disease and %84,6 in ulcerative colitis patients. Adalimumab and infliximab treatment were effective on healing of active disease in patients with inflammatory bowel disease. It was also concluded that although the safety of adalimumab and infliximab was high, but few allergy, lymphadenopathy and leukopenia side effects were observed. Keywords: Inflammatory bowel disease, crohn disease activity index, Truelove-wittz activity index, adalimumab, infliximab