Clinical outcome of adalimumab therapy in patients with ulcerative colitis previously treated with infliximab: a Danish single-center cohort study.

Abstract

OBJECTIVE:

TNF inhibitors are effective in the treatment of ulcerative colitis. Adalimumab (ADL), a fully human TNF inhibitor, is increasingly used both as primary anti-TNF agent and in patients switching from another TNF inhibitor due to treatment failure or side effects. This study investigated clinical outcomes of ADL therapy in a clinical setting where infliximab (IFX) had been used as first choice of anti-TNF agent, and followed by ADL as second line agent.

METHODS:

Retrospective, observational single-center cohort study including all ulcerative colitis patients treated with ADL at a tertiary Danish inflammatory bowel disease center until 2014. Clinical outcomes were assessed after 12 and 52 weeks and classified according to physician's global evaluation.

RESULTS:

The study population comprised 33 patients. Main reasons for switching from IFX to ADL were infusion reactions to IFX (45%) or IFX treatment failure (33%). Short-term efficacy of ADL after 12 weeks revealed 15 patients (45%) with clinical response, and 6 (18%) in clinical remission. Twenty-three patients continued ADL for more than 12 weeks, and at long-term follow-up after 1 year of ADL treatment, eight of these (34%) had clinical response (24% of the entire cohort) and six (26%) were in clinical remission (18% of the entire cohort). A total of five patients (15%) were colectomized mainly due to primary ADL failure (four of five patients).

CONCLUSION:

Efficacy of ADL therapy in ulcerative colitis patients previously treated with IFX appears to be modest in clinical practice, and with higher colectomy rates than reported for anti-TNF-naive patients in the registration trials.

• Authors: Katrine Risager Christensen, Casper Steenholdt, Jørn Brynskov
• Journal: Scandinavian journal of gastroenterology (Scand J Gastroenterol) Vol. 50 Issue 8 Pg. 1018-24 (Aug 2015) ISSN: 1502-7708 [Electronic] England
• PMID: 25861832 (Publication Type: Journal Article, Observational Study)

Chemical References

• Anti-Inflammatory Agents
• Tumor Necrosis Factor Inhibitors
• Infliximab
• Adalimumab

Topics

• Adalimumab (therapeutic use)
• Adult
• Anti-Inflammatory Agents (therapeutic use)
• Colectomy
• Colitis, Ulcerative (drug therapy)
• Denmark
• Female
• Humans
• Infliximab (therapeutic use)
• Male
• Middle Aged
• Remission Induction
• Retrospective Studies
• Tertiary Care Centers
• Time Factors
• Treatment Failure
• Treatment Outcome
• Tumor Necrosis Factor Inhibitors