Efficacy of adalimumab for the management of Inflammatory Bowel Disease in the Clinical Setting

Trinder, Matthew; Lawrance, Ian C.

doi:10.1111/j.1440-1746.2009.05786.x

Cited by 34 publications

(41 citation statements)

References 18 publications

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“…However, 77% (14/18) of the cases may achieve remission in week 48. These results also suggest that in patients with partial response to standard treatment with ADA, weekly injections could be an effective option, as shown by other studies (11,12). Other authors have observed acceptable remission rates even in patients with primary failure to IFX such as in the GAIN study (13)(14)(15).…”

Section: Discussionsupporting

confidence: 67%

Efficacy of adalimumab in patients with crohn's disease and failure to infliximab therapy: a clinical series

Cordero-Ruíz

Castro-Márquez

Méndez-Rufián

et al. 2011

Rev. esp. enferm. dig.

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Section: Discussionsupporting

confidence: 67%

Efficacy of adalimumab in patients with crohn's disease and failure to infliximab therapy: a clinical series

Cordero-Ruíz

Castro-Márquez

Méndez-Rufián

et al. 2011

Rev. esp. enferm. dig.

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“…The effect of vitamin D 3 on the CDAI scores was remarkable with all but one patient having a decrease in CDAI score and 78% of the patients had a drop of 70 points or more, which is considered a treatment response in the clinic. 20, 21 The vitamin D 3 effect was also reflected in the improved IBDQ scores, which is a second validated assessment tool used to monitor therapeutic efficacy in clinical trials of IBD. 22, 23 The IBDQ questionnaire consists of 32 questions scored in four domains: bowel symptoms, emotional health, systemic systems, and social function.…”

Section: Discussionmentioning

confidence: 99%

Therapeutic Effect of Vitamin D Supplementation in a Pilot Study of Crohn's Patients

Yang

Weaver

Smith

et al. 2013

Clinical and Translational Gastroenterology

155

141

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OBJECTIVES:Low vitamin D status may be associated with Crohn's disease. A pilot study was performed in patients with mild-to-moderate Crohn's disease to determine the dose of vitamin D needed to raise serum vitamin D levels above 40 ng/ml.METHODS:Patients were evaluated for severity of symptoms using the Crohn's disease activity index (CDAI) and patients with mild-to-moderate (150–400 CDAI scores) Crohn's disease were entered into the study (n=18). Vitamin D3 oral therapy was initiated at 1,000 IU/d and after 2 weeks, the dose was escalated incrementally until patients' serum concentrations reached 40 ng/ml 25(OH)D3 or they were taking 5,000 IU/d. Patients continued on the vitamin D supplements for 24 weeks. CDAI, quality of life measures, bone mineral density, dietary analyses, cytokines, parathyroid hormone, calcium, and several other laboratory measurements were evaluated at baseline and after 24 weeks supplementation.RESULTS:Fourteen of eighteen patients required the maximal vitamin D supplement of 5,000 IU/d. Vitamin D oral supplementation significantly increased serum 25(OH)D3 levels from 16±10 ng/ml to 45±19 ng/ml (P<0.0001) and reduced the unadjusted mean CDAI scores by 112±81 points from 230±74 to 118±66 (P<0.0001). Quality-of-life scores also improved following vitamin D supplementation (P=0.0004). No significant changes in cytokine or other laboratory measures were observed.CONCLUSIONS:Twenty-four weeks supplementation with up to 5,000 IU/d vitamin D3 effectively raised serum 25(OH)D3 and reduced CDAI scores in a small cohort of Crohn's patients suggesting that restoration of normal vitamin D serum levels may be useful in the management of patients with mild–moderate Crohn's disease.

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“…Adalimumab, a fully human IgG1 monoclonal antibody to TNF-, was found to be effective in patients with CD refractory to conventional therapy and in patients with an attenuated response to infliximab [211,227,228]. Recent study showed that adalimumab could induce and maintain clinical remission in patients with moderate-to-severe UC as well, who did not have a satisfactory response to steroids or immunosuppressive agents [229].…”

Section: Inhibition Of Pro-inflammatory Cytokines 3211 Inhibitorsmentioning

confidence: 99%

Gut Inflammation: Current Update on Pathophysiology, Molecular Mechanism and Pharmacological Treatment Modalities

Gyires¹,

Tóth²,

Zádori

2014

CPD

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Inflammatory bowel disease (IBD) is a chronic and relapsing inflammatory condition of the gastrointestinal tract. The two main forms of IBD are Crohn's disease and ulcerative colitis. According to the recent concept the disease is caused by a combination of factors, including genetics, immune dysregulation, barrier dysfunction and the change in microbial flora. Environmental factors, such as changes in diet, antibiotic use, smoking or improved domestic hygiene (e.g. eradication of intestinal helminths) probably contribute to the development and increased prevalence of IBD. Dysregulation of mucosal immunity in IBD causes an overproduction of inflammatory cytokines which resulted in uncontrolled intestinal inflammation. Based on extensive research over the last decade, besides the conventional therapy, there are several novel pathways and specific targets, on which focus new therapeutics. New therapeutics aim 1./ to correct genetic susceptibility by stimulating NOD2 expression, TLR3 signaling or inhibition of TLR4 pathway, 2./ to restore the immune dysregulation by inhibition of pro-inflammatory cytokines (TNF-, IL-6, IL-13, IL-17, IL-18, IL-21), Th1 polarisation (IL-2, IL-12, IL-23, IFN-), T-cell activation, leukocyte adhesion, as well as by immunostimulation (GM-CSF, G-CSF) and anti-inflammatory cytokines (IL-10, IL-11, IFN--1a), 3./ to restore mucosal barrier function and stimulate mucosal healing by different growth factors, such as GH, EGF, KGF, TGF-, VEGF, 4./ to restore the normal bacterial flora by antibiotics, probiotics. However, in spite of these numerous potential targets, the true value and clinical significance of most of the new biologics and molecules are not clear yet.

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Efficacy of adalimumab for the management of Inflammatory Bowel Disease in the Clinical Setting

Abstract: In CD, adalimumab is as, if not more, effective in the clinical setting than in the trials, and is effective in patients with an attenuated response to infliximab. Its efficacy is not as good in UC, but this requires further clarification.

Cited by 34 publications

References 18 publications

Efficacy of adalimumab in patients with crohn's disease and failure to infliximab therapy: a clinical series

Efficacy of adalimumab in patients with crohn's disease and failure to infliximab therapy: a clinical series

Therapeutic Effect of Vitamin D Supplementation in a Pilot Study of Crohn's Patients

Gut Inflammation: Current Update on Pathophysiology, Molecular Mechanism and Pharmacological Treatment Modalities

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