Efficacy and complications of adalimumab treatment for medically-refractory Crohn's disease: analysis of nationwide experience in Scotland (2004-2008).

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.

DOI: 10.1111/j.1365-2036.2008.03919.x
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@article{Ho2009EfficacyAC, title={Efficacy and complications of adalimumab treatment for medically-refractory Crohn's disease: analysis of nationwide experience in Scotland (2004-2008).}, author={Gwo-Tzer Ho and Alex Mowat and Lindsay Potts and Aiden Cahill and Craig Mowat and Charlie W. Lees and Nicola C Hare and Jason A. Wilson and R Boulton-Jones and Matthew Priest and David A. Watts and Alan G Shand and Ian D. R. Arnott and Richard Russell and D C Wilson and Arthur J Morris and Jack Satsangi}, journal={Alimentary pharmacology & therapeutics}, year={2009}, volume={29 5}, pages={527-34} }