İnflamatuar Barsak Hastalığında Adalimumab Tedavisinin Demir Parametreleri ve Anemi Üzerindeki Etkileri

Amaç: Bu çalışmada, Adalimumab tedavisinin inflamatuar barsak hastalığında (İBH) demir parametreleri ve aneminin seyri üzerindeki etkisini değerlendirmek amaçlanmıştır. Gereç ve yöntemler: 2016-2019 tarihleri arasında Sanko Üniversitesi Tıp Fakültesi Gastroenteroloji polikliniğinde takipli ve İBH nedeniyle Adalimumab tedavisi uygulanan 33 hasta (19 Crohn ve 14 ülseratif kolit) çalışmaya dahil edilmiştir. Hastaların; yaş, cinsiyet, laboratuvar verileri (kan hemoglobin (Hb), hematokrit (Htc), lökosit (WBC), trombosit (Plt), demir (Fe), demir bağlama kapasitesi (DBK), transferrin saturasyonu, ferritin, C‐reaktif protein (CRP) ve sedimantasyon düzeyleri) kaydedilmiştir. Tedavi öncesi ve 6. aydaki değerler karşılaştırılmıştır. Klinik aktivite ülseratif kolit için ortalama parsiyel Mayo skoru (pMayo) ve Crohn hastalarında ortalama Harvey-Bradshaw Index (HBI) puanları karşılaştırılarak tedavi etkinliği değerlendirilmiştir. Değişkenlerin analizinde SPSS 26.0 programı kullanılmıştır. Değişkenler %95 güven düzeyinde incelenmiş olup p değeri 0,05 ten küçük anlamlı kabul edildi. Bulgular: Sedimantasyon, CRP ve Plt değerlerinde tedavi sonrasında düşüş; Hb, Htc ve demir değerlerinde anlamlı yükselme saptanmıştır. Transferrin satürasyonunda ise yükselme gözlenmiştir. Ancak bu istatistiksel olarak anlamlı fark oluşturmamıştır. Hb ve Htc değerlerindeki artışın ülseratif kolit grubunda daha fazla olduğu saptanmıştır. Klinik pMayo ve HBI skorlarında ise anlamlı düşüş olduğu saptanmıştır. Sonuç: İBH nedeniyle Adalimumab tedavisi uygulanan hastalarda aneminin düzeliyor olması hastaların yaşam kalitesini de iyileştirecektir. Bu da uzun ve düzenli takip gerektiren bu hastalıkta hastaların tedaviye inancını ve uyumunu arttıracaktır.

Anahtar Kelimeler:

inflamatuar barsak hastalığı, ülseratif kolit, demir, anemi

Effects of Adalimumab Treatment on Iron Parameters and Anemia in Inflammatory Bowel Disease

Background: In this study, we aimed to evaluate the effect of Adalimumab treatment on iron parameters and the course of anemia in inflammatory bowel disease (IBD).Materials and Methods: Thirty-three patients (19 Crohn's and 14 ulcerative colitis) who received Adalimumab treatment for IBD who were followed up in the Gastroenterology outpatient clinic of Sanko University Faculty of Medicine between 2016-2019 were included in the study. Age, gender, laboratory data (blood hemoglobin (Hb), hematocrit (Htc), leukocyte (WBC), platelet (Plt), iron (Fe), iron binding capacity (DBK), transferrin saturation, ferritin, C - reaktif protein ( CRP) and sedimentation levels) of the patients were recorded. Pre-treatment and 6th month values were compared. Clinical activity the efficacy of treatment was evaluated by comparing the mean partial Mayo score (pMayo) for ulcerative colitis and the mean Harvey-Bradshaw Index (HBI) scores in Crohn’s patients. SPSS 26.0 program was used in the analysis of variables. Variables were analyzed at a 95% confidence level and a p value of less than 0.05 was considered to be significant.Results: Decrease in sedimentation, CRP and Plt values after treatment; and significant increase was found in Hb, Htc and iron values, respectively. An increase in transferrin saturation was observed. However, this did not create a statistically significant difference. It was determined that the increase in Hb and Htc values was more in the ulcerative colitis group. A significant decrease was found in clinical pMayo and HBI scores.Conclusions: Anemia improves in patients treated with Adalimumab for IBD, and this improvement is more pronounced in patients with ulcerative colitis.

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