Efficiency and safety of one-year anti-TNF-α treatment in Crohn’s disease: a Polish single-centre experience

Abstract

Introduction: Anti-TNF-α therapy of Crohn's disease (CD) represents considerable progress in inflammatory bowel disease (IBD) treatment; however, many patients still require surgical intervention. The Polish National Insurance Fund currently only covers up to 2 years of infliximab (IFX) therapy in CD patients and 1 year of adalimumab (ADA). Aim: To estimate the effectiveness and side effects of the anti-TNF-α Polish therapeutic program in CD patients. Material and methods: In this retrospective study, medical documentation of 80 CD patients treated with anti-TNF-α (IFX or ADA) was analysed. Fifty-two patients finished 1 year of therapy, and 28 individuals did not complete it due to lack of response to treatment or severe side effects. Results: After treatment, 27 (67.50%) patients achieved a semi-annual remission and 14 (35%) achieved yearly remission. Twenty percent of patients experienced severe side effects such as anaphylactic shock, pneumonia, shingles, or upper respiratory tract infections. A strong negative correlation between the number of patients in remission and the period since therapy termination (r =-0.996, p < 0.001) was found. During the 1-year follow-up, 20 patients were re-enrolled in the biological therapy program (the median time to next therapy was 231 days IQR: 126.5-300.5) Conclusions: Anti-TNF-α treatment in CD is relatively safe. The restricted time period of the therapy affects the clinical course of the disease and entails the need to resume biological therapy.

Primary Failure to an Anti-TNF Agent in Inflammatory Bowel Disease: Switch (to a Second Anti-TNF Agent) or Swap (for Another Mechanism of Action)?

“…In addition, a subset of patients who initially respond to anti-TNF drugs discontinue therapy because they lose their response (secondary non-responders) or develop an intolerable adverse event [5]. Finally, the restricted time period of the therapy in some countries affects the clinical course of the disease and entails the need to resume biological therapy [6].…”

Brain‐derived neurotrophic factor is elevated in the blood serum of Crohn's disease patients, but is not influenced by anti‐TNF‐α treatment—A pilot study

“…In IBD with severe clinical course, anti-TNF-α therapy is highly effective. 19,20 In a rat model, it has been shown that the administration of TNF-α increases the concentration of BDNF in colonic smooth muscle tissue. 2 Therefore, it seems warranted to study the effect of anti-TNF-α therapy on the BDNF level.…”

Determinants of Sleep Quality in Inflammatory Bowel Diseases

“…Shorter sleep time is associated with higher TNF level, while longer sleep time with an increased level of C-reactive protein and IL-6 [8,37]. Sleep deprivation causes many immunological phenomena that can affect the course of IBD; for example, TNF is secreted during sleep deprivation, which is a target for effective anti-TNF therapy of IBD [38][39][40].…”