Aim. To define the frequency of adverse events and loss of the response in patients with ulcerative colitis (UC) and Crohns disease (CD), treated with original medicine infliximab (IFX) Remicaide and its biosimilars. Materials and methods. We included 154 patients with IBD: 78 UC patients (50.6%) и 76 CD patients (49.4%), treated with original medicine IFX Remicade and its biosimilars. In our study we did not include patients, who previously underwent induction treatment with IFX and its biosimilar. Results. Among 78 UC patients, IFX was cancelled in 25 (32.0%) patients and they were switched to the other anti-TNF inhibitor or medicine with the another mechanism of action; in patients group, treated with biosimilar 16 (20.5%) and 9 (11.5%) patients, who were interchanged biosimilar and/or original IFX. Among 76 CD patients IFX was cancelled in 20 (26.3%) patients: 11 (14.5%) patients in group, treated with similar trade name biosimilar, 8 (10.5%) patients, who were interchanged biosimilar and/or original IFX and 1 patient (1,3%), receiving original IFX. We found no difference in the secondary loss of response and adverse events in patients with CD and UC, switched from original IFX to biosimilar (p=0.6257 and p=0.6635, correspondingly). The frequency of the secondary loss of response or adverse events in patients with UC and CD, switched from original IFX to IFX biosimilar, was similar (p0.05). Conclusion. Approximately 30% of IBD patients, receiving IFX biosimilar, will be switched to the other anti-TNF therapy or medicine with the another mechanism of action because of secondary loss of response or adverse events.

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Background: Previous research has shown smoking to have a deleterious effect on Crohn's Disease (CD) development, with smoking being identified as both a risk factor for CD and associated with poorer outcomes. Previous studies have shown smoking cessation interventions are associated with decreased rates of CD flares and lower rates of disease progression. While previous guidelines have called for increased focus on counseling for smoking cessation amongst CD patients, little research to date has demonstrated to what extent this counseling is routinely provided in an outpatient setting. Methods: We examined the rates of education for tobacco cessation among current and former smokers during visits for CD captured within the National Ambulatory Medical Care Survey (2002-2018) (NAMCS) and The National Hospital Ambulatory Medical Care Survey (2002-2011) (NHAMCS) database, a nationally representative dataset of outpatient visits. Patients with CD were identified using the International Classification of Diseases (ICD)-9-Clinical Modification codes 555.x as well as ICD-10-Clinical Modification codes K50. We analyzed rates of tobacco cessation counseling among all CD visits as well as CD visits for current/former tobacco users. In addition, a multivariable logistic regression model was performed to determine factors associated with rates of tobacco cessation counseling, including age, race, gender, geographic area and insurance type.Results: Among all visits for CD, the overall rate of counseling for tobacco cessation was 2.0% (95% CI: 1.1-3.5). The rate of counseling amongst former or current smokers with CD was slightly higher at 5.4% (95% CI: 2.9-10.0). In addition, rates of smoking cessation counseling were not significantly different between smokers with and without CD (P 5 0.26). In a multivariable logistic regression model, tobacco cessation counseling was less likely at visits with Hispanic patients compared to White, non-Hispanic patients with an aOR (adjusted odds ratio) of 0.06 (95% CI 0.01-0.30). Conclusion(s): Overall, rates of counseling and education for smoking cessation in outpatient CD visits were infrequent. Furthermore, lower rates of smoking cessation were noted in Hispanic patients compared to non-Hispanic patients, a finding documented in several previous studies. Though smoking has an important role in disease course and development, these findings indicate that education on smoking cessation does not frequently occur in the outpatient setting for CD patients. Overall, this highlights the need for increased focus by providers on screening and counseling for tobacco cessation in CD patients.