Background and importance Treatment of patients with moderate-severe corticosteroid-dependent or corticosteroid-refractory Crohn’s disease (CD) consist of biologically synthesised monoclonal antibodies. Due to the limited number of available drugs, optimal treatment monitoring is important to increase drug persistence and to maintain clinical remission.
Aim and objectives To describe the prescribed biological drugs in patients with CD and to compare the persistence of these treatments in first-line in comparison with subsequent therapies.
Material and methods A descriptive, observational, cross-sectional study was conducted in May 2021. All patients with CD and biological therapy were included. Data were obtained from the hospital information system. The following data were recorded: age, sex, prescribed biological drug, months since the treatment was started, dose and frequency, previous biological treatments and concomitant immunosuppressive therapy. Values are expressed as percentages and means (range).
Results A sample of 84 patients was obtained. The mean age was 48 (19–88) years and 43 (51.19%) were men.
Sixty-seven (79.76%) patients were on first-line treatment, 26 (38.81%) were prescribed adalimumab (ADA), 40 (59.70%) infliximab (IFX) and 1 (1, 49%) ustekinumab (UTK). Seventeen (20.24%) patients were on subsequent lines of treatment, 8 (47.06%) were prescribed ADA, 2 (11.76%) IFX and 7 (41.18%) UTK.
Forty-three (64.18%) patients who were on first-line treatment and 9 (52.94%) on subsequent lines of treatment were receiving concomitant immunosuppressive therapy.
The mean duration of treatment in first-line was 67 (0–167) months and in subsequent lines of treatment was 31 (4–97) months.
Sixteen (23.88%) patients who were on first-line treatment and 9 (52.94%) on subsequent lines of treatment received the drug at a higher dose or frequency than that indicated in the technical data sheet (intensified treatment).
Conclusion and relevance IFX was the most used monoclonal antibody in first-line, followed by ADA. However, ADA was the most prescribed in subsequent lines of therapies, followed by UTK.
In our study, first-line treatments maintained longer clinical persistence. However, more clinical data are needed to conclude that first-line treatments are most effective.
Subsequent therapies were less persistent despite being intensified in a greater number of patients.
Conflict of interest No conflict of interest