Infections in Patients with Inflammatory Bowel Disease on Biological Therapy in Zadar General Hospital

Ciljevi istraživanja: Utvrditi pojavnost infekcija kod bolesnika s upalnim bolestima crijeva na biološkoj terapiji koji se liječe u Općoj bolnici Zadar, te usporediti učestalost infekcija kod bolesnika na biološkoj terapiji u odnosu na druge vrste liječenja. Ispitanici i metode: Ispitanici su bolesnici s upalnim bolestima crijeva koji su na biološkoj terapiji, liječe se i prate u Općoj bolnici Zadar. U istraživanje je uključen 71 bolesnik. Prikupljanje i obrada podataka je provedeno iz Bolničkog informatičkog sustava Opće bolnice Zadar. Rezultati: Od ukupnog broja bolesnika (71) s upalnim bolestima crijeva koji se liječe i kontroliraju u Općoj bolnici Zadar i sudjelovali su u istraživanju, bio je 41 bolesnik (57,7%) i 30 bolesnica (42,3%). 12 bolesnika (16,9%) je imalo dijagnozu ulceroznog kolitisa dok je 59 bolesnika imalo dijagnozu Crohnova bolest (83,1%). Kod bolesnika je primijenjeno pet vrsta biološke terapije od koje je adalimumab primijenjen kod 33 bolesnika (46,5), ustekinumab je primijenjen kod 10 bolesnika (14,1%), vedolizumab je primijenjen kod 6 bolesnika (8,5%), infiximab je primijenjen kod 21 bolesnika (29,6%), dok je golimumab primijenjen kod samo jednog bolesnika (1,4%). Od ukupnog broja bolesnika s upalnim bolestima crijeva, njih 14 (19,6%) je razvilo infekciju, i to četiri (5.6%) virusom SARS-CoV-2, pet je bolesnika (7%) razvilo infekciju Clostridijom dificille, tri su bolesnika (4,2%) razvili pneumoniju, dok su dva bolesnika (2,8%) razvila infekciju Herpes zosterom. Zaključak: Ulcerozni kolitis i Crohnova bolest kronične su idiopatske upalne bolesti crijeva. Bolest ima relapsni i remisijski klinički tijek, zahtjeva doživotnu primjenu lijekova i često su prisutni različiti komorbiditeti. Zbog svoje prirode imunomodulacije tijekom primjene biološke terapije, postoji povećan rizik za razvoj infekcija kod bolesnika. Izuzme li se infekcija virusom SARS-CoV-2, samo je 10 od 71 bolesnika razvilo infekciju, što je 14,1%. Uspoređujući taj postotak s rezultatima ostalih istraživanja pronađenih sustavnim pretraživanjem literature, on uglavnom korelira s drugim istraživanjima pojavnosti infekcija kod bolesnika s upalnim bolestima crijeva.Aim of the research: To determine whether patients with inflammatory bowel diseases who developed infections during biological therapy at the Zadar General Hospital, and whether infections occur more often in patients on biological therapy compared to other types of treatment. Subjects and Methods: The research was conducted retrospectively. Subjects are patients with inflammatory bowel disease who are on biological therapy, treated and monitored at the Zadar General Hospital. The study included 71 patients. Data collection and processing was performed from the information system of the Zadar General Hospital. Results: Of the total number of patients (71) with inflammatory bowel disease treated and controlled at the Zadar General Hospital and participated in the study, there were 41 patients (57.7%) and 30 patients (42.3%). Regarding the diagnosis of inflammatory bowel disease, 12 patients (16.9%) were diagnosed with ulcerative colitis, while 59 patients were diagnosed with Crohn’s disease (83.1%). Five types of biological therapy were administered to patients, of which Adalimumab was administered in 33 patients (46.5), Ustekinumab was administered in 10 patients (14.1%), Vedolizumab was administered in 6 patients (8.5%), Infiximab was administered to 21 patients (29.6%), while Golimumab was administered to only one patient (1.4%). Of the total number of patients with inflammatory bowel disease, 14 (28.2%) developed infection, 10 (5,6%) with Covid-19 virus, five patients (7%) developed Clostridium dificille infection, 3 patients (4.2%) developed pneumonia, while two patients (2.8%) developed Herpes zoster infection. Conclusion: Ulcerative colitis and Crohn's disease are chronic idiopathic inflammatory bowel diseases. The disease has a relapsing and remission clinical course. Due to its immunomodulatory nature during the application of biologic therapy, there is an increased risk of developing infections in patients. Excluding Covida-19 virus infection, only 10 of 71 patients developed the infection, or 14.1%. Comparing this percentage with the results of other studies found by systematic literature search, it generally correlates with other studies of the incidence of infections in patients with inflammatory bowel disease