Early discontinuation of biological therapy among inflammatory bowel disease patients in Bahrain: Real world experience

Background: Despite the effectiveness of several biological agents in the treatment of inflammatory bowel disease (IBD), some patients respond better than others. Such discrepancies are often evident early in the treatment course. The aim of this study is to identify the risks and assess the rate of...

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Bibliographic Details
Published in:	Saudi journal of gastroenterology Vol. 28; no. 3; pp. 193 - 200
Main Authors:	Abdulla, Maheeba, AlQamish, Jehad, Mohammed, Nafeesa, Al Saeed, Mahmood, Al Aali, Hasan, Al Khaja, Aysha, Hasan, Zahra, Haider, Fatema, Ebrahim, Sayed, Mahfoodh, Zahra, Hubail, Mahmood, Alhajri, Isa, Al-Matrook, Fatema, Tork, Ahmed
Format:	Journal Article
Language:	English
Published:	India Wolters Kluwer India Pvt. Ltd 01-05-2022 Medknow Publications and Media Pvt. Ltd Medknow Publications & Media Pvt. Ltd Wolters Kluwer - Medknow Wolters Kluwer Medknow Publications
Subjects:	Adalimumab Aged Bahrain - epidemiology Biological Factors - therapeutic use Biological Therapy Care and treatment Chronic Disease Colitis, Ulcerative - drug therapy Colitis, Ulcerative - epidemiology crohn's disease Gastrointestinal diseases Humans Immunotherapy Inflammatory bowel disease inflammatory bowel diseases Inflammatory Bowel Diseases - drug therapy Inflammatory Bowel Diseases - epidemiology Medical research Medicine, Experimental Original Patients Retrospective Studies Tofacitinib ulcerative colitis Bahrain United Kingdom Biological therapy Crohn's disease ulcerative colitis inflammatory bowel diseases
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Summary:	Background: Despite the effectiveness of several biological agents in the treatment of inflammatory bowel disease (IBD), some patients respond better than others. Such discrepancies are often evident early in the treatment course. The aim of this study is to identify the risks and assess the rate of early biological discontinuation (BD) among IBD patients. Methods: In this retrospective cohort study conducted in Bahrain all IBD patients who were administered biological agents between June 2009 and June 2019 were included. Medical records were reviewed to collect study data and confirm IBD diagnoses. Early discontinuation of biological agents was defined by discontinuation of a biological agent (within 6 months from administration). Montreal classification was used to classify Crohn's disease and ulcerative colitis (UC) according to location and extension, respectively. Results: Ineffectiveness was the most common reason for early BD. Early BD was not related to the type of IBD, biological agent used, or to most patient-related factors (such as gender and family history). Patient age at index biological initiation was the only independent significant predictor of early BD (P = 0.045, adjusted odds ratios (95% CI): 1.06 (1.001-1.116)] even after correction of two significant factors: comorbid diabetes and marked weight loss at diagnosis. Conclusion: The older the IBD patient at the time of biological therapy initiation, the higher the incidence of early BD. Therefore, caution and close follow-up are required for biological therapy among elderly patients to assess effectiveness and adverse drug reactions.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1319-3767 1998-4049
DOI:	10.4103/sjg.sjg_336_21