Respuesta clínica al tratamiento biológico con anti factor de necrosis tumoral Alfa en pacientes con enfermedad inflamatoria intestinal en control en el Servicio de Gastroenterología del Hospital México desde enero del 2013 hasta julio del 2018
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La enfermedad inflamatoria intestinal (EII), comprendida principalmente por la enfermedad de Crohn (EC) y la colitis ulcerativa crónica idiopática (CUCI), es un trastorno crónico que alterna fases de recaída y remisión. Su fisiopatología incluye una respuesta inflamatoria inapropiada, que libera gran cantidad de citoquinas proinflamatorias, entre ellas se encuentra el factor de necrosis tumoral-α. Estas moléculas son blanco de distintos fármacos. Los antifactores de necrosis tumoral-α (TNF-α) son medicamentos biológicos que han demostrado ser efectivos en la inducción de respuesta clínica, remisión y remisión libre de esteroides en pacientes portadores de EII. El objetivo de este estudio fue determinar la respuesta clínica de los pacientes con EII tratados con terapia biológica con anti-TNF-α a la semana 24. Pacientes y métodos. Se realizó un estudio observacional, descriptivo de registros médicos, retrospectivo. En él se valoró la respuesta clínica de pacientes con EII en la semana 24 de tratamiento con anti-TNF-α en control en Gastroenterología del Hospital México en el periodo comprendido entre enero del 2013 y julio del 2018. Se incluyeron variables como sexo, edad, lugar de residencia, tipo de EII, edad del diagnóstico, tiempo de evolución antes del inicio del tratamiento biológico, la presencia de manifestaciones extraintestinales (MEI) asociadas, ciclos de esteroides previos y posteriores al inicio del biológico; parámetros de laboratorio previos y posteriores al inicio del tratamiento; fecha de inicio del biológico, nombre del biológico, puntuación del Crohn Disease Activity Index (CDAI) o Mayo previo y posterior al inicio del biológico; uso concomitantes de otros tratamientos y requerimiento de cambio de biológico. Se analizaron los parámetros cualitativos y cuantitativos, y se hicieron análisis univariados para comparar variables y su posibilidad...
Inglés: The inflammatory bowel disease, constituted mainly by Crohn’s disease and Chronic Idiopathic Ulcerative Colitis disease, is a long-term condition, which alternates phases of relapse and remission. Its physiopathology includes an inappropriate inflammatory response that releases a large amount of proinflammatory cytokines, including tumor necrosis factor α, molecules that end up being the target of a variety of drugs. The anti-tumor necrosis factor α are biological drugs that have proven to be effective in achieving a clinical response, remission and remission free of steroids in patients with inflammatory bowel disease. The objective of this research is to determine the clinical response after 24 weeks in patients with inflammatory bowel disease, when treated with biological therapy with anti-tumor necrosis factor α. Patients and Methods: An observational and retrospective cohort study alongside with a descriptive research was realized on medical records to evaluate the clinical response on the 24th week of inflammatory bowel disease patients who were being treated with anti- tumor necrosis factor α in the Gastroenterology department of Hospital Mexico in the time period comprehended between January 2013 to July 2018. Variables like sex, age, place of residence, type of inflammatory bowel disease, age of the diagnosis, time lapse before beginning biological treatment, presence of extraintestinal manifestations, steroid cycles used before and after beginning treatment, laboratory parameters before and after beginning treatment, date when the biological treatment began, type of the biological treatment, CDAI or Mayo score before and after beginning treatment, concomitant use of other drugs and the need of biological change. The qualitative and quantitative parameters were analyzed and univariate analysis were realized to compare the variables and their potential clinical response...
Inglés: The inflammatory bowel disease, constituted mainly by Crohn’s disease and Chronic Idiopathic Ulcerative Colitis disease, is a long-term condition, which alternates phases of relapse and remission. Its physiopathology includes an inappropriate inflammatory response that releases a large amount of proinflammatory cytokines, including tumor necrosis factor α, molecules that end up being the target of a variety of drugs. The anti-tumor necrosis factor α are biological drugs that have proven to be effective in achieving a clinical response, remission and remission free of steroids in patients with inflammatory bowel disease. The objective of this research is to determine the clinical response after 24 weeks in patients with inflammatory bowel disease, when treated with biological therapy with anti-tumor necrosis factor α. Patients and Methods: An observational and retrospective cohort study alongside with a descriptive research was realized on medical records to evaluate the clinical response on the 24th week of inflammatory bowel disease patients who were being treated with anti- tumor necrosis factor α in the Gastroenterology department of Hospital Mexico in the time period comprehended between January 2013 to July 2018. Variables like sex, age, place of residence, type of inflammatory bowel disease, age of the diagnosis, time lapse before beginning biological treatment, presence of extraintestinal manifestations, steroid cycles used before and after beginning treatment, laboratory parameters before and after beginning treatment, date when the biological treatment began, type of the biological treatment, CDAI or Mayo score before and after beginning treatment, concomitant use of other drugs and the need of biological change. The qualitative and quantitative parameters were analyzed and univariate analysis were realized to compare the variables and their potential clinical response...
Descripción
Tesis (especialidad en gastroenterología y endoscopía digestiva)--Universidad de Costa Rica. Sistema de Estudios de Posgrado, 2019
Palabras clave
INTESTINOS - INFLAMACION - EPIDEMIOLOGIA, INTESTINOS - INFLAMACION - TRATAMIENTO - COSTA RICA, TERAPIA BIOLOGICA