Impacto da remissão clínica induzida pelo infliximabe nos níveis de atividade física em pacientes com doença de Crohn em atividade

Abstract

Background: Patients with Crohn's Disease have a lower level of physical activity, a fact that is associated, at least in part, with the activity of the disease. Thus, it is relevant to compare the level of physical activity by the number of steps/day and the exercise capacity before and after the clinical remission induced by the biological therapy with infliximab. Objective: To evaluate the impact of clinical remission induced by infliximab on the level of physical activity and exercise capacity in patients with active Crohn's disease. Methods: In this prospective longitudinal study conducted between March of 2014 and June of 2017, 44 patients with active Crohn's disease were evaluated before and after 24 weeks of infliximab. They were evaluated for the level of physical activity using an accelerometer, exercise capacity, peripheral muscle strength and body composition. Results: After 24 weeks, 38 (86.4%) patients achieved clinical remission by infliximab and presented a significant increment from baseline in number of steps taken of 1092 (7440 ± 2980 vs. 6348 ± 3177 steps/day, respectively; p=0.006). The inactive time was significantly reduced when compared to baseline (454.2 ± 106.3 vs. 427.9 ± 97.8 minutes, respectively; p=0.033). There was no difference in the distance walked before and after infliximab therapy, while there was a significant increase on fat mass index in responders to infliximab compared to baseline period (19.1 ± 7.6 vs. 14.9 ± 5.8; p=0.001). Conclusions: Infliximab-induced remission was shown to be effective for increasing physical activity by improving the number of steps/day and reducing inactive time. The maintenance of clinical remission associated to incentives to regular physical activity may contribute to make that these patients reach an ideal level of physical activity.