Determining remission primary and secondary resistance ratios retrospectively in crohn patients WHO used biological agents and evaluation of the factors affecting these ratios

Crohn's disease (CH) is an inflammatory disease that can make focal, asymmetric, transmural involvement of the digestive system ,can involve the whole gastrointestinal system from mouth to anus, and also extraintestinal findings.Nowadays, Biological therapies, was started to be used in earlier periods due to evidence that changes the natural course of the CH. We have two type of biological therapies in our country,one of them are anti TNF agents (Adalimumab, Infliximab, Sertolizumab) and the other is anti integrin agent ,Vedolizumab. Eligible patients for the cohort are patients who followed up at Akdeniz University Medical Faculty Hospital Adult Gastroenterology Outpatient Clinic and clinic with the diagnosis of CD between 1 January 2010 - 1 February 2020 and at least 12 weeks adalimumab, infliximab, certolizumab, vedolizumab treatment has been given. Between biological agents, when they used as first line ,second line or third line treatment,there was no difference in the remission rate. We compare the psychiatric drug use rate between two group of patients ,one group was remission induced with single agent,other group had history of resistance to a biological agent at least once. Patients with a history of resistance to a biological agent were more likely to use psychiatric drugs.( % 27,7 – % 14,4) ( p= 0.02 ) Generic Infliximab and biosimilar infliximab were found to have a higher rate of drug intolerance compared to other biological agents; 10,4 and 10,6 percent (p= 0.04) We compare the disease localization of the two group of patients ,one group was remission induced with single agent,other group had history of resistance to biological agents at least once. Ileocolonic involvement was found at higher rates in those with a history of resistance. (% 66,3 – % 48,7) ( p = 0.01 ) We compare the disease behaviour of the two group of patients ,one group was remission induced with single agent,other group had history of resistance to biological agents at least once.Strictural type of disease was found to be significantly higher in patients with a history of resistance.(47,6 percent – 26,1 percent) (p = 0.01) Nonstrictural or non-penetrant type of disease was more common in patients who achieved remission on a single biological agent. (% 56.3 – % 32.7) ( p= 0.01 ) We compare the two groups of patient 's timing of initiation of the biological agent . Group with surgical history had a later initation to the biological agents.(51,77±44,01 months- 33,23±28,84 months). (p =0.01) The CRP values at the time of remission were found to be significantly lower than the CRP values at the time of first admission and primary or secondary resistance.