Comparation of inflammatory bowel disease therapy with an emphasis on immune therapy; results of research study of inflammatory bowel disease in the Osijek-baranja county 2000-2014

BACKGROUND: One of the significant health issues in modern era are ulcerative colitis (UC) and Crohn's disease (CD). Beneath clinical manifestation of those inflammatory bowel diseases (IBDs) lays chronic inflammation of gastrointestinal wall, mediated by the release of interleukins, cytokines and TNF. Drugs used in treatment are antibiotics, corticosteroids, immunomodulators and biological agents. Aim of this study was to compare usage of immunomodualting drugs vs. antibiotics and corticosteroids in treatment of IBDs during the time. Results in this study are part of results of the doctoral dissertation by M. Žulj, MD. MATERIAL AND METHODS:This study is based on medical documentation of IBD patients treated at KBC Osijek and OB Našice in the period of 2000-2014. In total of 78 patients, 51 was diagnosed with UC and 27 with CD. This study is a part of the university project "Povezanost polimorfizama jednog nukleotida u NOD 2 i MDR 1 genima s nastankom upalnih bolesti crijeva" VIF 2016-MEFOS 16 conducted at the University J.J.Strossmayer led by prof.dr.sc. A.Včev. RESULTS: At the beginning of treatment there was a statistical significant difference in usage of antibiotics between groups with UC and CD (32 UC, 10 CD, p=0, 03 χ2test), immunosupressants (11 UC, 15 CD, p=0, 001 χ2test) and biological agents (7 UC, 9 CD, p=0, 04 χ2test) while there was no statistical significant difference in usage of corticosteroids (36 UC, 21 CD, p=0, 59, χ2test). During this study drugs used in treatment of those patients were modified. Statistical significant differences were found in usage of biological agents (7 UC, 17 CD, p0, 99, χ2test), corticosteroids (13 UC, 3 CD, p=0, 13, χ2test) and immunosupressants (6 UC, 4 CD, p=0, 72, χ2test). CONCLUSION: Although drug groups used in treatment of UC and CD are similar, biological agents are mostly used in CD while corticosteroids are used in UC and CD equally, regardless of time of the treatment. Immunosupressants are mostly used in patients with CD while antibiotics in patients with UC at the beginning of treatment.