A cross-sectional study on pharmacotherapy and predictors of clinical remission in patients with inflammatory bowel disease

BACKGROUND: Inflammatory bowel disease (IBD) is a chronic, progressive, and disabling disorder that includes ulcerative colitis and Crohn's disease, characterized by periods of remission and relapse. Pharmacological management is the primary treatment option with the goal to induce mucosal healing and reduce relapse rates. OBJECTIVES: The main objective of the present study was to determine the pattern of pharmacotherapy and to evaluate the factors that predict clinical remission in patients with IBD. MATERIALS AND METHODS: A cross-sectional analysis was conducted involving fifty participants diagnosed with IBD. All the participants met predefined study inclusion criteria and voluntarily provided written informed consent. Data encompassing patient demographics, clinical parameters, prescribed medications, and ADRs were collected. The disease activity was evaluated using Simple Clinical Colitis Activity Index/Harvey-Bradshaw Index score. Univariate and multivariate logistic regression analysis was done to assess predictors of clinical remission. RESULTS: The commonly prescribed drugs were mesalamine in 72%, steroids in 50%, and azathioprine in 46% patients. 30% patients had an ADR to the prescribed drug; the most common ADR was anemia and pancytopenia with azathioprine use. 52% patients were in clinical remission. Univariate analysis identified medication adherence as a significant predictor, which was confirmed on multivariate analysis. Patient's adherent to medication were 32 times more likely to be in remission compared to nonadherent patients. CONCLUSION: Mesalamine and azathioprine were the most commonly prescribed monotherapy drugs. The most frequently prescribed combination therapies were mesalamine in conjunction with either steroids or azathioprine. Adherence to medication was the only factor statistically significantly linked to achieving clinical remission of the disease.