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THE INFLUENCE OF BIOLOGICAL THERAPY ON CD PATIENTS IN A SMALL URBAN AREA OF NORTH-WEST ITALY
Gabriela E. Nita*1, Giovanni Comi2, Laura Broglia2
1Emergency Department, Ospedale SS.Trinità borgomanero, Borgomanero, Novara, Italy; 2Gastroenterology department, Ospedale SS Trinità, Borgomanero, Novara, Italy
Introduction: Crohn’s Disease(CD) is a chronic recurrent bowel disorder of the gastrointestinal tract. Its chronic evolution, the relapses, the continuos improvement of medical therapies, shows anyway the lack of long period surveillace data for the patients'outcome.
Materials and method: We present our case series of 6-y follow-up for CD patients(pts) with biological therapy which were treated in a small urban area in North-West Italy. The treatment included involvement of a multidisciplinary team and the surgical pats were treated in 2 major centers of northern Italy.
Results: During a 6-y period we treated and followed 45 pts. 14 pt were suited for biological therapy due to unresponsivness to common therapies. All of those pts were A1 pts (100%), 10 pts had a l3 localisation(77%), 1 with l1(7,6%), 1 l2(7,6%), 1 l4(7,6%). As for disease behaviour there were 4 pts with b3 (30,8%), 2 with perineal presentation(15,4), 4 with b2(30,8%) and 3 with b1 presentation. The median age for these pts at the onset was 26 (13-33) years. The median period of follow-up was 11 years (3-19), the median period which the pts underwent biological therapy was 5 years.
4 of the 13 pts underwent surgery(2 need abdominal surgery and 2 underwent perineal procedures) and 9 were still ander medical treatment. 3 of the pts whom underwent surgery did not underwent biological treatment prior to surgery, but only after, in one case the biological treatment was for a few months prior to surgery. After the surgical treatment the in all the operated pts the clinical evolution was improved at 1 year follow-up. Only 1 of the 32 pts with no biological treatment underwent surgical treatment.
Also all the pts which underwent biological therapy showed clinical, biological and endoscopical improvement.
Discussion: The small case serie of short term period shown an increased compliace to treatment and the small number of pts are easy to follow. The lack of data for the medium and long term follow-up are due to the fact that in our hospital untill recently there was not possible follow-up these patients.
Conclusion: On small case series on short term follow-up the biological therapy is an usefull tool for the treatment of CD. there is still need of medium and long-term follow-up in order to have an image of the effect of these therapies.
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