Document Detail


Adalimumab in budesonide and methotrexate refractory collagenous colitis.
MedLine Citation:
PMID:  22149977     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: We described three patients with collagenous colitis (CC) who developed side effects or were refractory to both budesonide and methotrexate and were given adalimumab (ADA) as a third-line treatment.
METHOD/PATIENTS: Three patients (two women, mean age 45 years and one man, 74 years old) were included. Mean bowel movements per day per week were calculated and stool weight/24 h registered prior to and following ADA treatment. ADA was given in doses 160 mg s.c. (baseline), 80 mg (week 2) and 40 mg (week 4). Sigmoidoscopies with biopsies were performed at baseline and after 6 weeks to examine changes in histology. The Psychological General Well-Being Index (PGWBI) and Short Health Scale (SHS) were used at baseline and after 6 weeks.
RESULTS: The two female patients tolerated the treatment well. The male patient developed, despite clinical response, side effects (vomiting, abdominal pain) after 80 mg of ADA and the treatment was stopped as side effects reoccurred after rechallenge. The two women were in clinical remission at week 6 and the mean stool frequency per day decreased from mean 11 to 2. Mean stool weight/24 h changed from 600 to 185 g. The quality of life improved drastically in all patients. There were no consistent changes in histology.
CONCLUSION: ADA seems effective in budesonide and methotrexate refractory CC and can be administrated to selected patients to achieve clinical remission, improve quality of life and possibly avoid colectomy. Further studies for induction and maintenance treatment should be conducted to confirm efficacy and examine safety issues, even in long term.
Authors:
Andreas Münch; Simone Ignatova; Magnus Ström
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Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2011-12-08
Journal Detail:
Title:  Scandinavian journal of gastroenterology     Volume:  47     ISSN:  1502-7708     ISO Abbreviation:  Scand. J. Gastroenterol.     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2011-12-16     Completed Date:  2012-05-01     Revised Date:  2013-05-27    
Medline Journal Info:
Nlm Unique ID:  0060105     Medline TA:  Scand J Gastroenterol     Country:  England    
Other Details:
Languages:  eng     Pagination:  59-63     Citation Subset:  IM    
Affiliation:
Linköping University Hospital, Clinic of Endocrinology and Gastroenterology, Linköping, Sweden. andreas.munch@lio.se
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Anti-Inflammatory Agents / adverse effects,  therapeutic use*
Antibodies, Monoclonal, Humanized / adverse effects,  therapeutic use*
Biopsy
Budesonide
Colitis, Collagenous / drug therapy*,  pathology*,  physiopathology
Defecation
Drug Resistance
Female
Humans
Male
Methotrexate
Middle Aged
Quality of Life
Sigmoidoscopy
Tumor Necrosis Factor-alpha / antagonists & inhibitors
Chemical
Reg. No./Substance:
0/Anti-Inflammatory Agents; 0/Antibodies, Monoclonal, Humanized; 0/Tumor Necrosis Factor-alpha; 51333-22-3/Budesonide; 59-05-2/Methotrexate; FYS6T7F842/adalimumab

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


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