History

Background: Ulcerative colitis (UC) and Crohn's disease (CD) are chronic inflammatory bowel disorders (IBD). Biological therapy uses monoclonal antibodies against chronic inflammatory disease targets. Aim: To determine the primary response rate, the primary non-response rate (PNR) & the secondary loss of response rate (SLR) to biologic agents in patients with IBD. Also, to determine the side effect profile of biologic agents in patients with IBD. Patients and methods: This cross-sectional case series study was done in Azadi gastroenterology and hepatology center in Duhok, Iraq from March, 2022 to September, 2022. It included 40 IBD patients with diseased activity ranging from moderate to severe disease.  The male: female ratio was 1.7 and the mean age was 27.2 years ranging between 9-60 years. Results: Of the study population, 7 (17.5%) had UC and 33 (82.5%) had Crohn’s disease. The primary response rate was 62.5% (N=25) while the primary non response rate was 30% (N=12). The secondary loss of response rate was 7.5% (N=3) during the study period of 6 months. Mean CDAI was significantly reduced after second follow up of biological treatment (P=0.01) at 3 months of follow up. Patients on Remicade had the highest percentage of response and asymptomatic remission 83.3% compared to Remsima 59.3% and Adalimumab 0%.  Biological therapy side effects were positive in 5% (N=2) is the form of skin rash. Conclusions: Biologic therapy have an acceptable effectiveness and safety profile for patients with moderate to severe disease activity. However, more studies are warranted to establish the cause of PNR and SLR to increase the effectiveness of these medications in future.