Keywords
Crohn’s disease
mucosa healing
small intestine
adult
lidé
lidé středního věku
mladiství
monoclonal antibodies
mužské pohlaví
nemoc - stupeň závažnosti
pilotní projekty
prospektivní studie
statistika jako téma
střevní sliznice
střevo tenké
TNF-alfa
výsledek terapie
ženské pohlaví
adalimumab
infliximab
kapslové endoskopy
mladý dospělý
monoklonální protilátky humanizované
reprodukovatelnost výsledků
stupeň závažnosti nemoci
Abstract
Background: Efficacy of anti-TNFα therapy in mucosal healing of Crohn's disease in the small bowel is examined less than in the large bowel due to more difficult detection of mucosal changes.
Aim and methods: The aim of the prospective study was to assess the efficacy of anti-TNFα therapy in mucosal healing of small bowel CD using capsule endoscopy (CE). Patients with CD involving small (+/- large) bowel, who were indicated to anti-TNFα therapy were included.
Results: 25 patients (18 treated with infliximab, 7 with adalimumab) were examined by CE (Mirocam®, IntroMedic, South Korea) at the start of biologic treatment and 19 of them during the maintenance phase of therapy. Mucosal inflammatory changes were assessed by the Lewis score (LS).The median LS at base line was 1,350 (range 337-7,840) with 28% having mild (LS 135-790) and 72% moderate to severe mucosal inflammation (LS > 790). A significant reduction of LS to 402.5 with the range of 0-4,432 (p < 0.001) was observed after median of 32 weeks of treatment, with 83% of patients having only mild mucosal inflammation or normal mucosal finding (LS < 135). Only one (2.3%) capsule retention was observed; other complications were not observed.
Conclusion: Anti-TNFα therapy is effective in mucosal healing of small bowel CD. Capsule endoscopy detected mucosal changes effectively, was well tolerated and relatively safe.