Long-term efficacy of adalimumab in Paediatric Crohn's disease patients naive to other anti-TNF therapies
Introduction Adalimumab is a fully humanized anti TNF a antibody that has showed its efficacy in Crohn's disease (CD) adult patients Its less immunogenic composition seems to be an advantage compared to previous anti TNF alpha, mainly infliximab Good response to adalimumab has been reported in...
| Autores: | , , |
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| Tipo de recurso: | artículo |
| Estado: | Versión publicada |
| Fecha de publicación: | 2010 |
| País: | España |
| Institución: | Fundació Sant Joan de Déu |
| Repositorio: | r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu |
| OAI Identifier: | oai:fsjd.fundanetsuite.com:p1656 |
| Acceso en línea: | https://fsjd.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=1656 |
| Access Level: | acceso abierto |
| Palabra clave: | Adalimumab Anti TNF alpha Paediatric Crohn s disease Children |
| Sumario: | Introduction Adalimumab is a fully humanized anti TNF a antibody that has showed its efficacy in Crohn's disease (CD) adult patients Its less immunogenic composition seems to be an advantage compared to previous anti TNF alpha, mainly infliximab Good response to adalimumab has been reported in patients naive to infliximab, in those in whom infliximab has shown no efficacy and in those intolerant or who have lost previous response to it Adalimumab has shown also its efficacy as a second line anti TNF alpha in small series of paediatric CD but data regarding its use in children naive to infliximab are scarce Aim To report our experience with adalimumab as first line anti TNF alpha treatment in paediatric CD Patients and methods Four CD paediatric patients (2 boys) previously naive to infliximab have received adalimumab Mean age at diagnosis 13 years, 4 months Adalimumab was initiated in our patients soon after diagnosis (mean time from diagnosis 8 5 months, range 1 month 15days-14 months) at decreasing loading doses (160mg and 80mg two weeks after) and then 40 mg subsequently every two weeks Results The four patients entered in remission after the first dose of adalimumab (mean previous PCDAI 35, mean PCDAI after first dose 3 6) No adverse effects were registered Azathioprine was stopped after 4 months of combination therapy, without loss of efficacy or adverse reactions attributable to immunogenicity All the 4 patients have remained in remission on adalimumab monotherapy for a mean follow up of 17 months (range 9-20 months) Conclusion Adalimumab has shown its efficacy in our paediatric CD patients naive to other anti TNF alpha drugs Early introduction of anti TNF alpha antibodies in these patients could help to a better control of the disease Its less immunogenicity and the possibility of a home based administration are advantages when compared to other parenteral anti TNF treatments Change to monotherapy after prior successful combination therapy with azathioprine and adalimumab is a safe strategy that can help to minimize possible risks of intensive immunomodulation (C) 2010 European Crohn s and Colitis Organisation Published by Elsevier B V All rights reserved |
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