Year 2011 / Volume 103 / Number 6
Original
Efficacy of adalimumab in patients with Crohn

pp. 294-298

Patricia Cordero Ruiz, Cristina Castro Márquez, Vanesa Méndez Rufián, Luisa Castro Laria, Ángel Caunedo Álvarez, Javier Romero Vázquez y Juan Manuel Herrerías Gutiérrez

Abstract
Background: adalimumab, a human anti-TNF, is an effective induction and maintenance therapy for patients with moderate to severe Crohn s disease. It seems to be effective in patients with resistance
to infliximab, too, though the experience is more limited.
Aim: to evaluate the efficacy of adalimumab, in patients with Crohn s disease (CD) and failure to previous treatment with infliximab.

Methods: twenty-five patients with CD and failure to previous treatment with infliximab were enrolled; they were treated with 160/80 (24 patients) and 80/40 (1 patient) induction doses. We analyze clinical response to treatment with adalimumab by the Crohn’s disease Activity Index (CDAI) and plasma concentration of C-reactive protein (CRP), steroid sparing and complete fistula
closure at week 48.

Results: eighteen out of twenty-five patients (72%) achieved clinical remission (CDAI score < 150) at week 24 and 15/25 (60%) patients at week 48. There was a statistically significant difference (p < 0.01) in CRP serum levels from 21 to 8 mg/dl at week 48. Nine out of fifteen patients (60%) treated with corticosteroids
were able to discontinue steroids. Three out of eleven patients (27%) with fistulizing Crohn s disease had complete fistula closure after the treatment. Seventy two percent of the patients
(18/25) needed to increase adalimumab to weekly dose, in order to maintain clinical response. Five out of twenty-five patients (20%) had adverse events; two of them (8%) with serious adverse
events (tuberculous meningitis and abdominal abscess) that forced the withdrawal of treatment.

Conclusions: according to these data, adalimumab provides a clinical and analytical improvement in patients with CD and failure to previous therapy with infliximab.
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Patricia Cordero Ruiz, Cristina Castro Márquez, Vanesa Méndez Rufián, Luisa Castro Laria, Ángel Caunedo Álvarez, Javier Romero Vázquez y Juan Manuel Herrerías Gutiérrez. Efficacy of adalimumab in patients with Crohn. 294-298


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