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- Title
Efficacy and complications of adalimumab treatment for medically-refractory Crohn’s disease: analysis of nationwide experience in Scotland (2004–2008).
- Authors
HO, G. T.; MOWAT, A.; POTTS, L.; CAHILL, A.; MOWAT, C.; LEES, C. W.; HARE, N. C.; WILSON, J. A.; BOULTON‐JONES, R.; PRIEST, M.; WATTS, D. A.; SHAND, A. G.; ARNOTT, I. D.; RUSSELL, R. K.; WILSON, D. C.; MORRIS, A. J.; SATSANGI, J.
- Abstract
Background Adalimumab is a second generation humanized anti-tumour necrosis factor (TNF) monoclonal antibody with established efficacy in Crohn’s disease (CD). Aims To evaluate the efficacy and safety of adalimumab on a nationwide clinical setting. Methods We used the Scottish Society of Gastroenterology network to identify and follow up the clinical outcomes of patients with CD treated with adalimumab over a 4-year period (2004–2008). Results A total of 98 patients received adalimumab - 100.5 patient follow-up years were recorded (64.3% females; median age at diagnosis of 20.7 years; 88.8% treated with 80/40 mg induction regimen. Eighty eight (89.8%) had previous infliximab with 29 (32.9%) primary nonresponders; 32 (32.6%) were corticosteroid-dependent; 47 (47.9%) were intolerant/resistant to most immunosuppressive therapies (two or more). In all, 60% of patients were in clinical remission at 1-year follow-up, with 30% and 55% requiring dose escalation to weekly therapy at 1-and 2-year follow-up respectively. Overall, 29 (29.6%) patients developed complications with eight nonfatal serious (8.2%) adverse events and 2 (2.0%) case fatalities (sepsis following perforation and disseminated colorectal cancer, respectively). Conclusions Adalimumab is efficacious in severe and refractory CD in the clinical setting, although there remain significant therapy- and disease-related risks of serious complications.
- Subjects
CROHN'S disease; TUMOR necrosis factors; MONOCLONAL antibodies; CYTOKINES; COLON cancer
- Publication
Alimentary Pharmacology & Therapeutics, 2009, Vol 29, Issue 5, p527
- ISSN
0269-2813
- Publication type
Article
- DOI
10.1111/j.1365-2036.2008.03919.x