Reações adversas no tratamento da doença inflamatória intestinal em um Ambulatório de Referência / Adverse reactions in inflammatory bowel disease treatment in a Reference Center

Abstract

Introdução: A Doença Inflamatória Intestinal que compreende, principalmente, a Doença de Crohn e a Retocolite Ulcerativa, consiste em um grupo de condições inflamatórias crônicas que afetam predominantemente o trato gastrointestinal de indivíduos suscetíveis expostos a fatores de risco ambientais. Estudos recentes demonstram que a incidência e a prevalência da doença vêm aumentando em diferentes regiões do mundo. Em paralelo, há crescimento na utilização de imunomoduladores e terapias biológicas, tornando necessária a análise de seus riscos e impactos. Devido às terapias de longa duração com medicamentos sujeitos a efeitos nocivos, pacientes em vigência de tratamento podem evoluir com reações adversas. Objetivos: Analisar a ocorrência de reações adversas a medicamento durante o tratamento farmacológico de pacientes do Ambulatório de Referência de Doenças Inflamatórias Intestinais do Hospital Santa Casa de Misericórdia em Vitória – ES. Métodos: Estudo observacional e analítico de pesquisa documental retrospectiva através da coleta de dados durante o mês de outubro de 2020, em registros de pacientes em acompanhamento clínico. Conclusão: O perfil de reações adversas a medicamentos do estudo concordou majoritariamente com dados da literatura. Por meio desses dados será possível desenvolver estratégias voltadas ao rastreio, prevenção e redução das reações adversas a medicamentos, contribuindo para a diminuição da morbimortalidade e dos custos inerentes ao tratamento.Palavras chave: Reações adversas relacionadas a medicamentos, Efeitos colaterais, Doença de Crohn, Colite ulcerativa, Doenças inflamatórias intestinais ABSTRACT Introduction: Inflammatory Bowel Disease, which mainly comprises Crohn’s Disease and Ulcerative Colitis, consists of a group of chronic inflammatory conditions that predominantly affect the gastrointestinal tract of susceptible individuals exposed to environmental risk factors. Recent studies show that the incidence and prevalence of the disease has been increasing in different regions of the world. In parallel, there is a growth in the use of immunomodulators and biological therapies, making it necessary to analyze their risks and impacts. Due to long-term therapies with drugs subject to harmful effects, patients undergoing treatment may evolve with adverse reactions. Objective: To analyze the occurrence of adverse reactions to drugs during the pharmacological treatment of patients at the Reference Clinic for Inflammatory Bowel Diseases at Hospital Santa Casa de Misericórdia in Vitória - ES (HSCMV). Methods: This is an observational and analytical study of retrospective documentary research was carried out through of data during the month of October 2020, in patient records under clinical follow-up. Conclusion: The adverse drug reactions (ADR) profile of the study mostly agreed with data from the literature. Through these data, it will be possible to develop strategies aimed at screening, preventing and reducing ADRs, contributing to the reduction of morbidity and mortality and costs inherent to treatment. Keywords: Drug-related adverse reactions, Side effects, Crohn’s disease, Ulcerative colitis, Inflammatory bowel diseases

Drug‐Related Adverse Reactions in Pediatric Inflammatory Bowel Disease

“…8 In our study the incidence of ARs to biologics was 12.5%, which is within the range of previously reported data (6.0%-23.3%). 8,25 The most common ARs to biologics are infusion reactions, but none were observed in our study period, which may be explained by our hospital premedication protocol and also by the small sample size. 8,33 During the study period, there were no ARs to vedolizumab and ustekinumab.…”

“…8,25 The most common ARs to biologics are infusion reactions, but none were observed in our study period, which may be explained by our hospital premedication protocol and also by the small sample size. 8,33 During the study period, there were no ARs to vedolizumab and ustekinumab. Vedolizumab appears to have a favorable safety profile in comparison with other biologics, as its action is limited to the gastrointestinal tract, with lower rates of serious infections, infusion-related reactions, and malignancies over an extended period of time.…”

“…24 Adverse Reactions In our study, the incidence of IBD-related ARs was similar to that described in the few existing studies. 8,25 A recent retrospective study involving adult patients with IBD (n = 138) reported a 21.7% incidence of ARs. 8 Another previous study (n = 346) mentioned a 14.0% incidence of ARs, occurring mostly in patients under treatment with immunomodulators, followed by aminosalicylates and steroids.…”

“…8,25 A recent retrospective study involving adult patients with IBD (n = 138) reported a 21.7% incidence of ARs. 8 Another previous study (n = 346) mentioned a 14.0% incidence of ARs, occurring mostly in patients under treatment with immunomodulators, followed by aminosalicylates and steroids. 25 This is also in line with our results, as we found that biologics and steroids were more frequently prescribed in patients that had ARs, compared with patients that had none.…”

“…In parallel with the increasing prevalence of disease, drug prescriptions have also increased, making it necessary to analyze further the related risks and impacts. 8 Information about the incidence of ARs may provide a better understanding of the possible risks of different treatment options, which may ultimately improve the clinical care of patients with IBD. 2 However, there is a scarcity of studies regarding safety considerations, especially in pediatrics, and decisions are mostly based on the physician's clinical experience as well as studies in adult patients.…”