Abstract

I. Ouchicha*, H. Cherkaoui, A. Lamine, M. Lahlali, N. Lahmidani, A. EL Mekkaoui, DA. Benajah, A. Ibrahimi, M. Elyousfi, M. Abkari and H. Abid

ABSTRACT

The use of biological agents, particularly anti-TNF? (tumor-necrosis factor) drugs, has revolutionized the treatment of inflammatory bowel disease (IBD). However, up to 30% of patients show no clinical benefit after induction therapy (primary non-responders), and 30-40% of patients lose their response within the first year of treatment, requiring dose escalation or switching to another biological therapy. The study aims to identify factors of poor response. This is a retrospective descriptive and analytical study conducted by the Hepato-gastroenterology department of the Hassan II University Hospital of Fez, including 122 patients with IBD, of which 41 patients with UC (33.6%) and 81 patients with Crohn's disease (66. 4%), the mean age was 40.06 years, with a clear female predominance, 106 patients received initial treatment with infliximab-based biotherapy (86.88%), adalimumab in 15 of our patients (12.3%). Only one patient (0. 82%) was treated with Golimumab. A primary non-response was observed in 7.38% of the cases and a loss of secondary response in 23.77%. Sixty-one percent of the patients had clinical improvement of symptoms after the induction treatment without loss of secondary response. Seven patients presented an intolerance to anti-TNF alpha during the induction phase with switching to another biotherapy, and two patients did not have a well-conducted inducement therapy. A platelet count of more than 450,000 cells/mm3, a serum albumin level >30g/L, and good compliance with treatment were significantly associated with an excellent response to biotherapy.