医学
阿达木单抗
英夫利昔单抗
克罗恩病
内科学
不利影响
瘘管
胃肠病学
外科
维持疗法
疾病
化疗
作者
Patricia Cordero-Ruíz,Cristina Castro-Márquez,Vanesa Méndez-Rufián,Luisa Castro-Laria,Angel Caunedo-Álvarez,Javier Romero-Vázquez,Juan Manuel Herrerías‐Gutiérrez
标识
DOI:10.4321/s1130-01082011000600003
摘要
adalimumab, a human anti-TNF, is an effective induction and maintenance therapy for patients with moderate to severe Crohn's disease. It seems to be effective in patients with resistance to infliximab, too, though the experience is more limited.to evaluate the efficacy of adalimumab, in patients with Crohn's disease (CD) and failure to previous treatment with infliximab.twenty-five patients with CD and failure to previous treatment with infliximab were enrolled; they were treated with 160/80 (24 patients) and 80/40 (1 patient) induction doses. We analyze clinical response to treatment with adalimumab by the Crohn's disease Activity Index (CDAI) and plasma concentration of C-reactive protein (CRP), steroid sparing and complete fistula closure at week 48.eighteen out of twenty-five patients (72%) achieved clinical remission (CDAI score < 150) at week 24 and 15/25 (60%) patients at week 48. There was a statistically significant difference(p < 0.01) in CRP serum levels from 21 to 8 mg/dl at week 48.Nine out of fifteen patients (60%) treated with corticosteroids were able to discontinue steroids. Three out of eleven patients (27%) with fistulizing Crohn's disease had complete fistula closure after the treatment. Seventy two percent of the patients (18/25) needed to increase adalimumab to weekly dose, in order to maintain clinical response. Five out of twenty-five patients (20%) had adverse events; two of them (8%) with serious adverse events (tuberculous meningitis and abdominal abscess) that forced the withdrawal of treatment.according to these data, adalimumab provides a clinical and analytical improvement in patients with CD and failure to previous therapy with infliximab.
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