الفهرس 
ULCERATIVE COLITISOnly 14 pages are availabe for public view
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Abstract
I
nflammatory bowel disease (IBD) is a chronic disease characterized by intestinal inflammation with a relapsing and remitting clinical course that generally requires lifelong medication and is associated with significant morbidity, hospitalization needs, and productivity losses.
Furthermore, the disease is progressive, with damage accumulation and treatment failure over time. Additionally, IBD is considered a systemic disease, with extra-intestinal manifestations and symptoms frequently affecting the joints, skin, eyes, and (although less often) the liver, pancreas, or lungs, which can also contribute to morbidity and reduced quality of life.
This study was a retrospective prospective descriptive in nature which aimed to evaluate the outcome of Ulcerative colitis patients after one year of biological therapy.
It was held in the Inflammatory Bowel disease outpatient clinic, Tropical Medicine department, Ain Shams University Hospitals, from Jan. 2020 to June 2021.
After one year of biological therapy, 17 patients discontinued biological treatment. The reasons for stopping the biologics were due to failure of remission and presence of complications.
Regarding the laboratory investigations before and after one year of treatment, there was no statistically significant difference. While there was statistically significant difference found between pre- and after- one year regarding the hospitalization rate.
According to blood transfusion, there was no statistically significant difference found between pre- and after-one year. While there was statistically significant difference regarding disease severity.
There was statistically significant difference found between pre- and after-one year regarding Mayo endoscopic Sub score, and also there was statistically significant difference found between the two group regarding follow-up at one year by Mayo scoring.
CONCLUSION
• There are a variety of IBD treatments available, ranging from conventional to biological or small molecules. Biological therapy is very successful in the treatment of IBD. However, limited available choices were present at the time of our study.
• Despite the efforts made in recent years to fill the gap in the mechanistic knowledge of biologics, particularly regarding anti-TNF-α therapies, further studies are needed to fully understand the action of mechanism of these drugs, which will help understand how to improve the efficacy and safety. These studies will hopefully pave the path to a personalized medicine.
• There is a need for multicenter study to avoid overestimation to complications, success rate and failure rate to obtain accurate data.
• After 1-year follow up, clinical response was significantly high (75%). On the other hand, clinical remission was only 46.4%.
• Introduction of biological therapy to severe UC patient improve mayo score and mayo endoscopic sub score.
• Biologics decrease the need for hospitalization significantly and decrease need for blood transfusion which means that the rates of severe attacks decrease among these group of patients.
• 75% of the patients were controlled on biologics and immunomodulatory treatment.
• Long term follow-up study is required to detect resistance and treatment failure for biologics and incidence of colorectal carcinoma among this population.
• We need to follow up patients who shifted to another types of biologics as a second line of therapy and compare degree of effectiveness between biologic naïve and biologic experienced patients.