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P548. Biological agents in Crohn's disease: When?

E. Saritas Yuksel1, C. Cekic1, F. Topal1, Z.Z. Gumus1, B. Unsal1, Z. Akpinar1, 1IKÇU Ataturk Research and Teaching Hospital, Gastroenterology, Izmir, Turkey

Background

Crohn's disease is a complicated disease with clinical manifestations changing for each patient and treatment decision sometimes become complicated. After the use of biological agents, frequency of surgery, hospitilization and morbidity seem to decrease. Also, with contributions of clinical studies and increased experiences, the side effects of biological agents are in acceptable levels with close follow-up of patients. Now the question is that when we should begin the biological agents in Crohn's disease. We have studied if there is a tendency in our clinic to start the biological therapy earlier in the last year compared to the previous years.

Methods

In our clinic, 41 Crohn's disease patients are treated with biological agents. The patients were divided into two groups according to the introduction time of the biological treatment. Twenty-three patients started the treatment before August 2012 (Group A). Between August 2012 and July 2013, 18 patients started the biological agents (Group B). These two groups were compared according to their disease severity previous to the treatment initialisation and follow-up ‘well-being’ results.

Results

One month before the treatment, SES-CD (Group A - 8.5 vs Group B - 6) and CDAI (Group A - 323 vs Group B - 244) scores were higher in Group A. Also after treatment, global assessment was questioned and quality of life was found lower in Group A. In each follow-up, every patient is questioned as “Do you feel well today?” and “Are you better than before?”. Yes was counted as one point and no was counted as zero point. Total points were divided to the number of follow-ups. The patients in group A had significantly lower points than the ones in group B.

Conclusion

Our approach to the Crohn's disease patients differed in the recent years due to the mewly published data. It seems that initializing the biological treatment in the earlier stages is more beneficial and needs further investigation.