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Monitoring of infliximab treatment in inflammatory bowel diseases – basic knowledge and current data based on clinical trials in a population of Polish patients

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Pękala A.
European Journal of Clinical and Experimental Medicine
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2022
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issue 3
251-259
EN
Introduction and aim. Infliximab is the oldest biological drug belonging to the group of tumor necrosis factor antagonists. Despite the availability of many new biological therapies, this drug still plays an important role in the treatment of inflammatory bowel diseases. However, a significant problem related to pharmacotherapy is the high inter-individual variability of the response. Material and methods. This study presents results of the research on the treatment with infliximab in the inflammatory bowel disease (IBD) patients including our own experience in Polish IBD patients. Analysis of the literature. Therapeutic failure while using infliximab can be attributed partly to inadequate serum concentrations of the drug and the development of anti-drug antibodies. Many studies have attempted to find a relationship between the specific level of infliximab and the achieved healing effect. These analyses show that the optimal level of the drug differs depending on the type of disease, its phenotype, and therapeutic goal and that the optimization of infliximab therapy remains an open topic. Two studies involving the population of Polish IBD patients examined the level of infliximab during and after induction, as well as the frequency of anti-drug antibodies. Two studies involving a population of Polish IBD patients examined the level of infliximab during and after induction, as well as the frequency of anti-drug antibodies. These studies demonstrated the need for monitoring infliximab treatment at weeks 6 and 14. Conclusion. Reactive monitoring is believed to enable the most rational treatment decisions; however, experts also recommend that proactive monitoring should measure infliximab concentrations at the end of induction and at least once during maintenance treatment.
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Infliximab in therapy of inflammatory bowels diseases

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Piotr Bar P., Sabina Galiniak S., Dorota Bartusik-Aebisher D., Rafał Filip R., David Aebisher D.
European Journal of Clinical and Experimental Medicine
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2019
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issue 1
79-82
EN
Introduction. Infliximab is a monoclonal antibody that acts against tumor necrosis factor TNF-α. The drug is used in the treatment of autoimmune diseases. Aim. This article reviewed the efficacy and safety of infliximab for the treatment in severe ulcerative colitis. This review included studies that evaluated the clinical use of infliximab. Material and methods. This meta-analysis was performed according to systematic literature search of three major bibliographic databases (Scopus, PubMed, and Cochran). Results. Infliximab has been approved by the US Food and Drug Administration (FDA) as a medicine to treat Leśniowski and Crohn’s disease, ulcerative colitis, psoriasis, psoriatic arthritis, ankylosing spondylitis, and rheumatoid arthritis. However, further trials are required to compare other parameters of efficacy such as the clinical response with infliximab. Conclusion. In patients suffering from Crohn’s disease or ulcerative colitis under infliximab maintenance therapy, sustained good trough levels are associated with: better response and remission rates, more mucosal healing and less loss of response.
3
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Macro and micronutrient deficiency in inflammatory bowel diseases

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Sara Jarmakiewicz S., Dominika Piątek D., Rafał Filip R.
European Journal of Clinical and Experimental Medicine
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2017
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issue 4
342-348
EN
Introduction. Inflammatory bowel disease (IBD) is group of global range inflammatory conditions. There has been a regular increase in the number of IBD cases. Patients exclude whole food groups from their diet fearing the emergence of disease symptoms or due to learning from unreliable sources. Doing so, they might deepen the already existing vitamin deficiencies which occur along with the shortage of many minerals. These deficiencies might intensify the disease process or cause a new one. The most common deficits pointed out by numerous researchers concern vitamin D, calcium, cobalamin, folic acid and iron. It is well worth introducing selenium, zinc and ascorbic acid into a diet because of their immunomodulating effect. Important aspect of the healing process is a personalized diet which is designed to compensate for, or prevent vitamin and mineral deficiencies. Aim. The purpose of the study was to review the literature about vitamin and mineral deficiency in Inflammatory Bowel Diseases. Materials and method. Analysis of literature
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Ulcerative colitis: effect on fertility and pregnancy

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Ouzounιdou A., Koukourikos K., Kourkouta L., Tsaloglidou A.
Progress in Health Sciences
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2015
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vol. 5
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issue 1
185-191
EN
Introduction: Ulcerative colitis is one of the most interesting nosological entities of gastroenterology and internal medicine. This chronic autoimmune disorder of the digestive system, along with Crohn's disease, is a type of idiopathic inflammatory bowel disease. It mainly affects people during their peak reproductive age, i.e., 15 to 30 years old. It is characterized by diffuse mucosal inflammation of the large intestine, which is limited to the colon and shows alternating periods of exacerbations and remissions. Purpose: To review the world literature regarding the impact of the disease on fertility, the course of pregnancy, and consecutively, the outcome of pregnancy.Materials and methods: An extensive review of the recent national and international literature in electronic databases (Pubmed, Google Scholar) and in scientific journals was accomplished through the use of appropriate keywords. Results: The majority of women will have a chance of conceiving. For about 25% of them, conception will be achieved in the course of the disease and it will progress normally, resulting in a healthy fetal outcome. Infertility only occurs among men while they are taking medicines, whereas among women it occurs after surgery for ileoanal anastomosis. During periods of flare-ups, there is a possibility of spontaneous abortion, premature labor and birth of an infant with low birth weight. The majority of pharmaceutical formulations can be used safely both before and after pregnancy without causing any birth defects.
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Teória vzťahovej väzby a nešpecifické zápalové ochorenia čreva

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Bednaříková H., Kaščáková N., Zelinková Z., Tavel P.
Československá psychologie (Czechoslovak Psychology)
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2019
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vol. 63
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issue 2
226-238
EN
As a chronic condition, inflammatory bowel disease (IBD) significantly reduces the quality of life of young working age population. The etiopathogenesis of IBD is multifactorial, combining several genetic and environmental factors. Psychosocial aspects that affect the progress of the disease and may have therapeutic effects on the disease are currently being extensively studied, and a clear conceptual approach to their role in IBD management has yet to be identified. The attachment theory states that a relation to a primary caregiver is critical to forming relations with others and to viewing the world around us. A sense of security seems to protect us against psychological disorders and somatic diseases. The paper presented is a synthesis of previous studies dealing with individual expressions of the attachment theory and their effect on the progress and the management of the disease, offering a potential pathogenetic mechanism of the attachment with respect to the origin and development of IBD.
SK
Nešpecifické zápalové ochorenia čreva (inflammatory bowel disease – IBD) ako chronické ochorenia výrazne redukujú kvalitu života mladých ľudí v produktívnom veku. Etiopatogenéza IBD je multifaktoriálna s kombináciou viacerých genetických a enviromentálnych faktorov. Psychosociálne aspekty ovplyvňujúce priebeh ochorenia a umožňujúce jeho terapeutické ovplyvnenie sú aktuálne extenzívne študované, ale jednoznačný konceptuálny pohľad na ich rolu v manažmente IBD zatiaľ chýba. Teória vzťahovej väzby vyjadruje základnú myšlienku, že vzťah k primárnej vzťahovej osobe ovplyvňuje to, akým spôsobom sa staviame v živote ku všetkým ďalším vzťahom a ako vnímame svet. Bezpečný vzťahový štýl sa zdá byť ochranný pred vznikom tak psychických ako somatických ochorení. Predkladaná práca predstavuje syntézu doterajších štúdií zaoberajúcich sa jednotlivými typmi vzťahových štýlov a ich vplyvu na priebeh a manažment ochorenia s vysvetlením potenciálne patogenetického pôsobenia neistých štýlov vzťahovej väzby na vznik, vývoj a priebeh IBD.
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