Gastroenterology

Management of chronic inflammatory bowel diseases in the era of biotherapy monitored in the wilaya of Constantine/Algérie (January 2019-December 2021)

Global Journal of Gastroenterology & Hepatology Research [GJGHR]

Author: Dr. Hicham Bouhouche Medical sciences Constantine university (Algeria)
Biography: Baccalaureate of secondary education in natural and life sciences series June 1998.
Graduation in medical sciences at the Faculty of Medicine of Algiers.
Doctorate in medicine: November 2005.
General practitioner: Period 2005 – 2010.
Residency competition in 2009 at the Faculty of Medicine of Algiers.
Diploma of specialized medical studies in April 2015.
Appointment and tenure in the body of university hospital assistant professors April 2018.
State doctorate in medical sciences (DESM) after public thesis defense, February 21, 2023 with honorable mention with congratulations from the jury and proposals for exchanges with foreign universities.

Introduction:
Chronic inflammatory bowel disease is a chronic inflammatory condition of the digestive system of multifactorial origin mainly represented by Crohn’s disease and ulcerative colitis. In addition, inflammation of the intestine predisposes to an increased risk of CRC. In the age of biological therapies, new therapeutic goals include induction and maintenance of mucosal healing, mucosal healing may change the natural history of ulcerative colitis and Crohn’s disease.

The aim of this study is to specify the indications for biotherapy and the type of response obtained in our patients, and to determine the post-treatment evolving factors and the criteria for therapeutic monitoring.

Patients and methods:
This is a bicentric prospective analytical observational study of 130 patients with IBD who were on anti-TNFα, comprising 87.7% of Crohn’s disease, an average age of 34 years with an extreme of 16 years to 69 years, 53.8 % of men and the average seniority of the pathology had evolved over the past 5 years. Extra-digestive manifestations only found in 23.1%, of which osteo-articular manifestations are the most frequent. Pancolic localization in UC is predominant and ileocolic presented in more than half of cases for Crohn’s disease, with 36% of associated phenotype (B2 + B3).

The main indication for anti-TNFα is failure of conventional immunosuppressant therapy, where anoperineal lesions are most indicated for treatment for Crohn’s disease. ADA is the most widely used treatment in our series and only 38.5% of patients were on combination therapy.

Results:
During the study period, the failure of anti-TNFα in 14.6% of cases. The use of optimization of anti-TNFα therapy in 30% avoids a large number of failures in 81.8% of patients optimized where optimization of ADA treatment seems to prevent more failure than the IFX, for a lower price. Intolerance to anti-TNFa treatment is rare, dominated by dermatological effects (hypersensitivity. The predictors of loss of anti-TNFα response in our series were: type of IBD (especially for UC), type of treatment (much failure with ADA), ileocolic topography and stenosis. -penetrating CD so patients were put on monotherapy.

Keywords:
Chronic inflammatory bowel disease, Crohn’s disease, ulcerative colitis, management, biotherapy, infliximab, adalimumab, optimization, failure, good response, predictive factors.

Conclusion:
The use of biotherapies in our patients made it possible to obtain and maintain clinical remission with mucosal healing and to reduce the need for corticosteroids and decrease the rate of hospitalization and the need for surgery and, moreover, to improve life quality.

To citation of this article: Dr. Hicham Bouhouche, Baccalaureate of secondary education in natural and life sciences series June 1998. Graduation in medical sciences at the Faculty of Medicine of Algiers. Global Journal of Gastroenterology & Hepatology Research

Tags
Crohn’s and Colitis Journals | Gastroenterology & Hepatology Journals | Gastroenterology Journals | Research Gastroenterology and Hepatology Journals | Clinical and Experimental Gastroenterology Journals | Gastrointestinal Endoscopy Journals | Therapeutic Advances in Gastroenterology Journals | Colorectal Disease: clinical and molecular gastroenterology and surgery Journals | Inflammatory Bowel Diseases Journals | Expert Review of Gastroenterology & Hepatology Journals | Clinical Colorectal Journals | Cancer Gut Journals | Endoscopy Journals | Hepatitis B Annual Journals | Hepato-biliary-Pancreatic Sciences Journals | Medical Bulletin Journals

Back to top button