Document Detail


Clinical experience with infliximab and adalimumab in a single-center cohort of patients with Crohn's disease.
MedLine Citation:
PMID:  22472026     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND AIMS: Patients with Crohn's disease (CD) may need anti-inflammatory drugs for decades. Anti-TNF-α agents have good efficacy and adverse events similar to placebo in randomized controlled trials (RCTs), but there are still questions about long-term safety and efficacy. In this respect, reports from clinical practice may be useful. We currently report on the clinical experience with infliximab and adalimumab in a single-center cohort of patients with CD.
MATERIAL AND METHODS: Patients with CD treated with infliximab or adalimumab from 2000 to 2010 were reviewed. Patient and disease characteristics at start, reason for discontinuation, and adverse events were recorded retrospectively. Corticosteroid use, the need for hospitalization, and surgeries before and during anti-TNF-α therapy were recorded.
RESULTS: Eighty-three patients had received anti-TNF-α treatment against CD, median treatment duration was 11.4 months (0.2-99.5), and follow-up time 59 months (8-135). Eighteen of 43 patients using corticosteroids at treatment start discontinued corticosteroids during TNF-α therapy. Need for hospitalizations (6.13 vs. 3.28 days/year, p < 0.001) and surgeries (0.56 vs. 0.16 operations/year, p < 0.001) were lower during anti-TNF-α therapy than before treatment. Twenty-six percent discontinued therapy due to adverse events and 26% due to lack or loss of response. Two of four deaths observed during follow-up were believed to be related to anti-TNF-α treatment.
CONCLUSIONS: Anti-TNF-α therapy was beneficial in many patients with CD, but the majority of patients discontinued treatment during follow-up. Reports from clinical experience with anti-TNF-α treatment may be valuable for clinicians treating patients with CD.
Authors:
Ase Riis; Tom C Martinsen; Helge L Waldum; Reidar Fossmark
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't     Date:  2012-04-04
Journal Detail:
Title:  Scandinavian journal of gastroenterology     Volume:  47     ISSN:  1502-7708     ISO Abbreviation:  Scand. J. Gastroenterol.     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-05-08     Completed Date:  2012-08-31     Revised Date:  2013-05-27    
Medline Journal Info:
Nlm Unique ID:  0060105     Medline TA:  Scand J Gastroenterol     Country:  England    
Other Details:
Languages:  eng     Pagination:  649-57     Citation Subset:  IM    
Affiliation:
Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
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MeSH Terms
Descriptor/Qualifier:
Adrenal Cortex Hormones / therapeutic use
Adult
Anti-Inflammatory Agents / adverse effects,  therapeutic use*
Antibodies, Monoclonal / adverse effects,  therapeutic use*
Antibodies, Monoclonal, Humanized / adverse effects,  therapeutic use*
Cohort Studies
Crohn Disease / drug therapy*,  mortality,  surgery
Female
Follow-Up Studies
Hospitalization / statistics & numerical data
Humans
Male
Medication Adherence
Retrospective Studies
Treatment Outcome
Chemical
Reg. No./Substance:
0/Adrenal Cortex Hormones; 0/Anti-Inflammatory Agents; 0/Antibodies, Monoclonal; 0/Antibodies, Monoclonal, Humanized; 0/infliximab; FYS6T7F842/adalimumab

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