Biologická liečba ponúka nové možnosti konzervatívnej liečby IBD, vďaka ktorej sa výrazne zredukovala potreba chirurgickej liečby pacientov a výrazne sa im zlepšila kvalita života. V Centre biologickej liečby Gastroenterologickej kliniky SZU v Bratislave sa v súčasnosti používajú dve látky bielkovinovej povahy, pripravené metódou génového inžinierstva, infliximab – chimérická monoklonálna anti-TNF-alfa protilátka a adalimumab – rekombinantná monoklonálna anti-TNF-alfa protilátka. Tento článok sa zaoberá našimi doterajšími skúsenosťami s biologickou liečbou 59 pacientov, jej pozitívnym efektom aj nežiaducimi účinkami. Aktuálne je v liečbe 45 pacientov – 28 s Crohnovou chorobou a 17 s ulceróznou kolitídou. Najčastejšou indikáciou biologickej liečby boli u pacientov s Crohnovou chorobou fistuly (8 pacientov). Priemerná hodnota CDAI u pacientov s Crohnovou chorobou pred začatím liečby bola 216. Po podaní indukčnej dávky biologickej liečby poklesla na 103. Slizničné hojenie sme zaznamenali u 16/28 pacientov s Crohnovou chorobou a u 12/17 pacientov s ulceróznou kolitídou. Biologická liečba bola prerušená u 13/59 pacientov, najčastejšie pre alergiu (4 pacienti) a nonrespondibilitu (4 pacienti).

Biological therapy represents new possibilities of conservative treatment of IBD. It has led to a significant reduction in the need of surgical treatment of the patients and resulted in a significant improvement in the quality of their lives. The Centre of biological therapy of Gastroenterology clinic of SZU in Bratislava uses two agents of protein nature at present. The agents are prepared by the method of genetic engineering, infliximab – chimeric monoclonal antibody to TNF-alpha and adalimumab – recombinant monoclonal antibody to TNF-alpha. This article is dealing with our latest experience with the biological therapy of IBD in 59 patients, with its positive effects as well as its side effects. Actually there has been 45 patients under ongoing treatment – 28 with Crohn’s disease and 17 patients with ulcerative colitis. The most frequent indication for biological treatment were fistulas indicated in 8 patients with Crohn’s disease. The average value of CDAI in patients with Crohn’s disease before beginning of the treatment was 216. After administration of the induction dose of biological treatment it declined to 103. We noticed mucosal healing in 16/28 patients with Crohn’s disease and 12/17 patients with ulcerative colitis. Biological treatment was interrupted in 13/59 patients. Mostly due to allergy reactions (4 patients) and non-respondibility (4 patients).

Our experience with biological therapy in inflammatory bowel disease ( ibd)