Adalimumab for Crohn’s disease with intolerance or lost response to infliximab: a 3-year single-centre experience
Article first published online: 25 NOV 2008
© 2009 Blackwell Publishing Ltd
Alimentary Pharmacology & Therapeutics
Volume 29, Issue 4, pages 416–423, February 2009
How to Cite
OUSSALAH, A., BABOURI, A., CHEVAUX, J.-B., STANCU, L., TROUILLOUD, I., BENSENANE, M., BOUCEKKINE, T., BIGARD, M.-A. and PEYRIN-BIROULET, L. (2009), Adalimumab for Crohn’s disease with intolerance or lost response to infliximab: a 3-year single-centre experience. Alimentary Pharmacology & Therapeutics, 29: 416–423. doi: 10.1111/j.1365-2036.2008.03902.x
- Issue published online: 8 JAN 2009
- Article first published online: 25 NOV 2008
- Publication data Submitted 15 October 2008 First decision 31 October 2008 Resubmitted 5 November 2008 Accepted 18 November 2008 Epub Accepted Article 25 November 2008
Background Adalimumab is effective in inducing clinical remission in patients with Crohn’s disease who lost response or became intolerant to infliximab.
Aim To evaluate long-term efficacy and safety of adalimumab as a second line therapy in luminal and fistulizing Crohn’s disease.
Methods We report our single-centre experience in 53 patients. We evaluated maintenance of clinical response defined as the absence of adverse events leading to drug withdrawal, no major abdominal surgery and no loss of clinical response in initial responders. Major abdominal surgery, steroid sparing, complete fistula closure and safety were also assessed.
Results The probability of maintaining clinical response was 77.2%, 67.8% and 50.8% at 26, 52 and 130 weeks respectively. The probability of remaining major abdominal surgery-free was 82.3% at 26, 52 and 130 weeks. Complete fistula closure occurred in six of 10 patients, and eight of 10 patients were able to taper steroid therapy. Adverse events occurred in 31 patients (58.5%) leading to adalimumab withdrawal in nine patients (17%).
Conclusion Adalimumab therapy may be effective in the long term in both luminal and fistulizing Crohn’s disease in infliximab-failure patients, half of patients maintaining clinical response and potentially avoiding major abdominal surgery in 80% of cases.