Adalimumab Treatment in Pediatric-Onset Crohn’s Disease Patients after Infliximab Failure: A Single Center Study
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Purpose: We aimed to investigate the efficacy and safety of adalimumab in pediatric-onset Crohn’s disease patients who had failed treatment with infliximab.Methods: In this retrospective study, patients included were those who had been diagnosed with Crohn’s disease before 18 years old, and had received treatment with adalimumab after infliximab failure. The efficacy of adalimumab treatment was investigated at 1 month and 1 year, and adverse events that had occurred during treatment with adali-mumab were explored. Results: Ten patients were included in this study. The median duration from diagnosis to adalimumab treatment was 5.5 years (range: 2.4-7.9 years). At 1 month after adalimumab initiation, 80% (8/10) of patients showed clinical response, and 40% (4/10) achieved clinical remission. At 1 year, 71% (5/7) of patients showed clinical response, and 43% (3/7) were under clinical remission. Among the total included patients, 5 patients (50%) showed clinical response at 1 year. Primary non-response to adalimumab was observed in 2 patients (20%), and secondary failure to adalimumab was observed in 3 patients (30%) during 1 year treatment with adalimumab. No serious adverse event had occurred during adalimumab treatment. Conclusion: Adalimumab was effective for 1 year without serious adverse events in half of pediatric-onset Crohn’sdisease patients who had failed treatment with infliximab.
Abstract
Purpose: We aimed to investigate the efficacy and safety of adalimumab in pediatric-onset Crohn’s disease patients who had failed treatment with infliximab.Methods: In this retrospective study, patients included were those who had been diagnosed with Crohn’s disease before 18 years old, and had received treatment with adalimumab after infliximab failure. The efficacy of adalimumab treatment was investigated at 1 month and 1 year, and adverse events that had occurred during treatment with adali-mumab were explored. Results: Ten patients were included in this study. The median duration from diagnosis to adalimumab treatment was 5.5 years (range: 2.4-7.9 years). At 1 month after adalimumab initiation, 80% (8/10) of patients showed clinical response, and 40% (4/10) achieved clinical remission. At 1 year, 71% (5/7) of patients showed clinical response, and 43% (3/7) were under clinical remission. Among the total included patients, 5 patients (50%) showed clinical response at 1 year. Primary non-response to adalimumab was observed in 2 patients (20%), and secondary failure to adalimumab was observed in 3 patients (30%) during 1 year treatment with adalimumab. No serious adverse event had occurred during adalimumab treatment. Conclusion: Adalimumab was effective for 1 year without serious adverse events in half of pediatric-onset Crohn’sdisease patients who had failed treatment with infliximab.
참고문헌 (23)
- Baumgart DC, "Inflammatory bowel disease: clinical aspects and established and evolving therapies", Lancet, 369, pp.1641~1657 (2007)
- Louis E, "Behaviour of Crohn's disease according to the vienna classification: changing pattern over the course of the disease", Gut, 49, pp.777~782 (2001)
- Thia KT, "Risk factors associated with progression to intestinal complications of Crohn's disease in a population- based cohort", Gastroenterology, 139, pp.1147~1155 (2010)
- Hanauer SB, "Maintenance infliximab for Crohn's disease: the ACCENT I randomised trial", Lancet, 359, pp.1541~1549 (2002)
- Sands BE, "Long-term treatment of rectovaginal fistulas in Crohn's disease: response to infliximab in the ACCENT II Study", Clin Gastroenterol Hepatol, 2, pp.912~920 (2004)
- Hyams J, "Induction and maintenance infliximab therapy for the treatment of moderate- to-severe Crohn's disease in children", Gastroenterology, 132, pp.863~873 (2007)
- Yanai H, "Assessing response and loss of response to biological therapies in IBD", Am J Gastroenterol, 106, pp.685~698 (2011)
- Hanauer SB, "Human anti-tumor necrosis factor monoclonal antibody (adalimumab) in Crohn's disease: the CLASSIC-I trial", Gastroenterology, 130, pp.323~333 (2006)
- Sandborn WJ, "Adalimumab for maintenance treatment of Crohn's disease: results of the CLASSIC II trial", Gut, 56, pp.1232~1239 (2007)
- Colombel JF, "Adalimumab for maintenance of clinical response and remission in patients with Crohn's disease: the CHARM trial", Gastroenterology, 132, pp.52~65 (2007)
- Hyams JS, "Safety and efficacy of adalimumab for moderate to severe Crohn's disease in children", Gastroenterology, 143, pp.365~374.e2 (2012)
- Levine A, "ESPGHAN revised porto criteria for the diagnosis of inflammatory bowel disease in children and adolescents", J Pediatr Gastroenterol Nutr, 58, pp.795~806 (2014)
- Levine A, "Pediatric modification of the montreal classification for inflammatory bowel disease: the paris classification", Inflamm Bowel Dis, 17, pp.1314~1321 (2011)
- Lee YM, "Infliximab "Top-Down" strategy is superior to "Step-Up" in maintaining long-term remission in the treatment of pediatric Crohn disease", J Pediatr Gastroenterol Nutr, 60, pp.737~743 (2015)
- Allez M, "Report of the ECCO pathogenesis workshop on anti-TNF therapy failures in inflammatory bowel diseases: definitions, frequency and pharmacological aspects", J Crohns Colitis, 4, pp.355~366 (2010)
- Rosh JR, "Retrospective Evaluation of the Safety and Effect of Adalimumab Therapy (RESEAT) in pediatric Crohn's disease", Am J Gastroenterol, 104, pp.3042~3049 (2009)
- Russell RK, "A british society of paediatric gastroenterology, hepatology and nutrition survey of the effectiveness and safety of adalimumab in children with inflammatory bowel disease", Aliment Pharmacol Ther, 33, pp.946~953 (2011)
- Cozijnsen M, "Adalimumab therapy in children with Crohn disease previously treated with infliximab", J Pediatr Gastroenterol Nutr, 60, pp.205~210 (2015)
- Fumery M, "Efficacy and safety of adalimumab after infliximab failure in pediatric Crohn disease", J Pediatr Gastroenterol Nutr, 60, pp.744~748 (2015)
- Frederiksen MT, "Antibodies against infliximab are associated with de novo development of antibodies to adalimumab and therapeutic failure in infliximab- to-adalimumab switchers with IBD", Inflamm Bowel Dis, 20, pp.1714~1721 (2014)
- Rutgeerts P, "Adalimumab induces and maintains mucosal healing in patients with Crohn's disease: data from the EXTEND trial", Gastroenterology, 142, pp.1102~1111 (2012)
- Jones JL, "Effects of concomitant immunomodulator therapy on efficacy and safety of anti- tumor necrosis factor therapy for Crohn's disease: a meta-analysis of placebo-controlled trials", Clin Gastroenterol Hepatol, 13, pp.2233~2240 (2015)
- Osterman MT, "Increased risk of malignancy with adalimumab combination therapy, compared with monotherapy, for Crohn's disease", astroenterology, 146, pp.941~949 (2014)
