Optimization of biological therapy in patients with ulcerative colitis (case report)

Now in Russia registered two biological drugs for the treatment of UC is infliximab and golimumab. The largest experience with the use of infliximab (IFX) shows that, despite the high efficiency, in some patients the IBD (20-30%) will develop acquired secondary loss of response to the drug. The development of secondary loss of anti-cytokine therapy is influenced by the following causes - irregular administration of the drug, monotherapy with monoclonal antibodies, initial high levels of TNF-α and low albumin, the presence of antibodies to the drug, activation of opportunistic infections, and changes in pathogenesis of the disease. The appearance at present in the arsenal of gastroenterologists of golimumab (GLM) has expanded the possibilities of treatment of patients with UC in the case of secondary loss of response to therapy with anti-TNF-α or the development of adverse events on IFX. This clinical case shows that after discontinuation IFX, there is a risk of recurrence of the disease, which according to the literature is 50 %. The example also demonstrated that GLM is well tolerated in patients who develop adverse events on IFX in the form of anaphylaxis. This is because GLM are fully human inhibitor of TNF-α. Golimumab is a new, effective inhibitor of TNF-α, which may help to optimize therapy in UC.