The Outcome of Ulcerative Colitis Patients after One Year of Biological Therapy

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Background Inflammatory bowel disease (IBD) comprises two types, namely, the ulcerative colitis (UC) and Crohn’s disease (CD). They are a spectrum of chronic idiopathic autoimmune inflammatory disorders with remission and relapses, primarily affecting the gastrointestinal system, UC is characterized by confluent mucosal inflammation and erosions starting from the anal verge and extending to a variable extent, where Patients often complain of diarrhea associated with rectal bleeding, abdominal tenderness, and weight loss A number of biological agents have been approved by the U.S Food and Drug Administration (FDA) for te treatment of UC. Objectives The aim beyond this study is to assess the effect of biological therapy after one year on ulcerative colitis patients regarding clinical manifestations, hospitalization, number of severe attacks, laboratory investigations, colonoscopy and histopathology. Patients and Methods The studied patients were selected from patients presented to IBD study group clinic.tropical medicine department in Ain Shams University hospitals. total number of cases during the study period was 28 cases fulfilling the inclusion criteria. Results The mean age of the patients was 30.14 ± 7.65. The majority of the cases were sightly more common in females. The duration of illness ranged from 1-10 years with median 3 years (2 - 5.5). the majority of the patients had pan colitis (75%). there were 19 biologic-naive patients (67.9 %) and 9 biologic-experienced patients (32.1%). In our study, 16 patients (57.1%) received adalimumab, 11 patients (39.3%) received infliximab and only one patient received ustekinumab. The majority of cases (71.4%) were taking azathioprine as a combination therapy with biologics. the majority of the patients (75%) achieved clinical response at 1-year follow-up.While clinical remission achievied in only 46.4% Conclusion Biological treatments are very successful in the therapy of IBD. However, these treatments are still expensive and new patients with IBD must begin first with the traditional treatments without knowing if they will work for them.