Complications and optimalisation of Mesalazine and anti-TNF-alpha therapy in inflammatory bowel disease

Dorien Joke Buurman

    Research output: ThesisThesis fully internal (DIV)

    877 Downloads (Pure)


    Inflammatory bowel diseases (IBD) are chronic inflammatory bowel diseases characterized by intestinal ulcers. The most well-known IBD are Crohn's disease and ulcerative colitis. The most common used drug treatment for ulcerative colitis is mesalazine. In addition, treatment with anti-TNF-alpha (such as the biologicals infliximab and adalimumab) is an important drug therapy for IBD. The aim of this thesis is to optimize treatment with mesalazine and anti-TNF-alpha in IBD.
    We describe patients with ulcerative colitis who get an inflammatory response, kidney or liver damage due to mesalazine. For patients who use anti-TNF-alpha, we describe methods to measure these antibodies and antibodies to these antibodies and we showed that this is useful. We show that the antibodies against the original infliximab also react with an imitated version (a biosimilar) of infliximab so that this biosimilar should not be used in patients with these antibodies. Infliximab is given as an infusion. We describe a study protocol with tablet administration. We show that some people have a hereditary susceptibility to get kidney problems after mesalazine and develop antibodies to administered antibodies. A genetic passport could predict this chance of side effects and the risk of developing antibodies. Measuring drug levels of biologicals is useful and early detection of the development of antibodies against these biologicals will improve treatment with these drugs. New tablet forms that deliver drugs precisely at the site of the inflammation is a promising development for the future treatment of IBD.
    Original languageEnglish
    QualificationDoctor of Philosophy
    Awarding Institution
    • University of Groningen
    • Dijkstra, Gerard, Supervisor
    • Weersma, Rinse, Supervisor
    Award date6-Nov-2019
    Place of Publication[Groningen]
    Print ISBNs978-94-034-1928-2
    Electronic ISBNs978-94-034-1929-9
    Publication statusPublished - 2019

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