Document Detail


Adalimumab in Crohn's disease: tips and tricks after 5 years of clinical experience.
MedLine Citation:
PMID:  21291363     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Three anti TNF-α agents have currently been approved for the treatment of moderate-to-severe or complicated Crohn's disease (CD): infliximab, certolizumab and adalimumab. Infliximab is effective in CD, but for reasons linked to its chimeric structure, response to treatment may be lost overtime and as a result, it can sometimes be unable to provide long term durable treatment of CD. Adalimumab, a fully human anti TNF-α antibody, demonstrates similar treatment efficacy as infliximab and certolizumab, and can easily be self-administered at home.
AIM AND METHODS: A literature search in the Cochrane, MEDLINE, PUBMED, Ovid MEDLINER® and EMBASE databases has been performed on the efficacy, safety and the impact adalimumab has on the quality of life and natural history of CD. Abstracts presented at the DDW, UEGW and ECCO Congresses have also been reviewed as well as references from review articles, meta-analysis studies and published RCTs.
RESULTS: Adalimumab induced remission of CD in 64% of patients, and maintained remission in more than 80% of initial responders. Adalimumab did not significantly increase the risk of adverse events compared with conventional medication up to 3 years of follow-up. Adalimumab reduces more than 50% the risk for hospitalisation and surgery due to CD. It is also effective for fistula closure, for the healing of the mucosa, and improving quality of life.
CONCLUSION: Adalimumab is effective in the induction and maintenance of clinical remission in CD and is generally well tolerated. It has been proved to have a positive impact by improving quality of life of patients, and reducing the need for hospitalisation and surgery due to CD. According to the European Crohn's and Colitis Organisation (ECCO), infliximab or adalimumab can be used for the treatment of fistulizing CD.
Authors:
G Fiorino; H Szabò; W Fries; A Malesci; L Peyrin-Biroulet; S Danese
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current medicinal chemistry     Volume:  18     ISSN:  1875-533X     ISO Abbreviation:  Curr. Med. Chem.     Publication Date:  2011  
Date Detail:
Created Date:  2011-03-15     Completed Date:  2011-08-01     Revised Date:  2013-05-27    
Medline Journal Info:
Nlm Unique ID:  9440157     Medline TA:  Curr Med Chem     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  1230-8     Citation Subset:  IM    
Affiliation:
IBD Unit, Gastroenterology, IRCCS Humanitas, Rozzano, Milan, Italy.
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MeSH Terms
Descriptor/Qualifier:
Antibodies, Monoclonal / therapeutic use*
Antibodies, Monoclonal, Humanized
Crohn Disease / drug therapy*,  surgery
Humans
Remission Induction
Chemical
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/Antibodies, Monoclonal, Humanized; FYS6T7F842/adalimumab

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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