Epidemiological profile of 175 patients with Crohn's disease submitted to biological therapy

Abstract

Introduction: There is currently an increasing use of biological agents in the management of Crohn's disease (CD). There is lack of data regarding the epidemiological profile of patients on infliximab (IFX) and adalimumab (ADA) for CD in Brazil. Objective: To identify the epidemiological characteristics of patients with CD who underwent biological therapy. Method: Retrospective multicenter study, with CD patients on biological therapy. Analyzed variables: gender, age at treatment initiation, Montreal classification, concomitant perianal disease and smoking status. Results: 175 patients without previous exposure to biological agents were included, 93 (53%) were male. The mean age at treatment initiation was 35.5 (2-79) years old an the mean disease duration was 46.9 (0-480) months. Overall, 117 (66.9%) patients used IFX and 58 (33.1%), ADA. Montreal classification: age at diagnosis-A1 (n=21; 12%), A2 (n=102; 58.3%), and A3 (n=52; 29.7%). CD location-L1 (n=42; 24%), L2 (n=51; 29.1%), L3 (n=81; 46.3%), and L4 (n=1, 0.6%). Phenotype-B1 (n=59; 33.7%), B2 (n=46; 26.3%), and B3 (n=70; 40%). Perianal disease was found in 89 (50.9%) patients. Conclusions: The epidemiological profile of patients was similar to the literature. There was a high prevalence of patients with fistulizing CD.

Epidemiology of inflammatory bowel disease in Mexico and Colombia: Analysis of health databases, mathematical modelling and a case-series study

“…[50]One study found a higher prevalence of left-sided colitis, higher mortality, and higher usage of biological agents in Mexican population than in Mexican-American population, supporting the role of environmental factors on clinical characteristics of IBD. [24] The larger case-series in LAC Countries are from 1946 to date are from Argentina [14,51,52], Barbados [13], Brazil [14,[53][54][55][56][57][58][59][60][61][62][63][64][65], Chile [66][67][68], Cuba [69], Peru [70,71], Puerto Rico [72][73][74][75] and Uruguay. [76][77][78] Most CD localizations were ileal-colonic and CD behavior was mostly inflammatory, followed by penetrant or stenotic.…”

Mudanças No Consumo Alimentar E Nas Condições Psicossociais Geradas Pela Doença Inflamatória Intestinal

“…Além disso, alguns relatos sugerem o impacto da doença na vida profissional: um dos pacientes referiu se sentir mal com as faltas e as saídas antecipadas, por saber que seu chefe "não gosta"; uma mulher alegou ter sofrido um acidente de trânsito, gerado pelo estresse ao ter perdido o emprego; outro paciente se aposentou por invalidez, devido à colocação de bolsa coletora; e dois outros referiram ter se afastado, em decorrência da ocupação que tinham, uma por trabalhar como manipuladora de alimentos e os sintomas gastrointestinais colocarem em risco a segurança do alimento; e o outro por ser pescador, já que os sintomas lhe impossibilitavam de permanecer em alto-mar. Para Hardt et al 15 , o impacto no trabalho também se dá pelo distúrbio ocorrer principalmente entre adolescentes e adultos jovens, grupo etário de grande produtividade.…”

“…Enquanto a DC é um processo inflamatório transmural que pode afetar todo o trato gastrointestinal de maneira descontínua. Ambas têm como característica a alternância de episódios de atividade e remissão, e extensão variáveis 3,13,15 .…”

“…Dessa forma, aspectos emocionais poderiam agravar os sintomas ou provocar recidivas. Além disso, as DII comprometem a qualidade e a expectativa de vida dos pacientes e representam um impacto social e psicológico importante 8,9,15,18 .…”

Women respond better to biological therapy in Crohn's Disease

“…Crohn's disease (CD) is in itself a major challenge for those treating inflammatory bowel diseases. Patients presenting with the fistulizing form, particularly perianal fistulas, create even more of a challenge, as there is great difficulty in controlling the disease even with the therapeutic advances for long-term treatment made in recent years 1 .…”