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Update on the management of inflammatory bowel disease: specific role of adalimumab Full Text
Clinical and Experimental Gastroenterology, 07/18/2011
Clinical Article
Guidi L et al. – Results of the first randomized, controlled trial on adalimumab for ulcerative colitis (UC) showed that adalimumab at 160/80 mg induction dose was safe and effective for inducing remission and clinical response after 8 weeks in patients with moderately-to-severely active UC failing treatment with corticosteroids and/or immunosuppressants.
Methods- Adalimumab is the first fully human monoclonal immunoglobulin directed against tumor necrosis factor(TNF)-α, which binds with high affinity and specificity to membrane and soluble TNF.
- Adalimumab administered subcutaneously has demonstrated efficacy in the treatment of rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, and severe chronic psoriasis.
- Studies have shown that adalimumab is effective for inducing and maintaining remission of moderate-to-severe active Crohn’s disease (CD) patients at an induction dose of 160/80 mg (week 0 and 2) and at a maintenance dose of 40 mg every other week.
- Efficacy of adalimumab as a second-line therapy has also been documented for patients with loss of response or intolerance to infliximab.
- Adalimumab is also superior to placebo for inducing and maintaining complete perianal fistula closure.
- It also seems effective for reducing extraintestinal manifestations.
- Safety profile is similar to that of other anti-TNF therapy in CD patients, with lower immunogenicity and rate of adverse injection reactions than infliximab.
- Adalimumab is not approved for the treatment of UC.
