Adalimumab induction and maintenance therapy for ulcerative colitis patients previously treated with Infliximab.
Résumé
Background: The long term efficacy of adalimumab in ulcerative colitis (UC) patients is not well known. Aim: To evaluate the short- and long-term outcomes of adalimumab in UC patients previously treated with infliximab. Methods: Patients with active UC were treated with adalimumab after failure of other therapies including infliximab. Short-term clinical response and remission were assessed at weeks 4 and 12. The proportion of patients who continued on adalimumab and the proportion of patients who remained colectomy-free were assessed over the long term. Results: Clinical response at weeks 4 and 12 was achieved in 16 (53.3%) and 18 (60%) patients, respectively, and clinical remission was obtained in 3 (10%) and 8 (26.7%) patients, respectively. After a mean 48 weeks follow-up, 15 patients (50%) continued on adalimumab. Six patients (20%) required colectomy. All patients who achieved clinical response at week 12 were colectomy-free at long term. Conclusions: Adalimumab was well tolerated and induced durable clinical response in many patients with otherwise medically refractory UC. Patients achieving clinical response at week 12 avoided colectomy over the long term.
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