Long-term efficacy of adalimumab in Paediatric Crohn's disease patients naïve to other anti-TNF therapies

Martín-de-Carpi, Javier; Pociello, N.; Varea, V.

doi:10.1016/j.crohns.2010.04.002

Cited by 22 publications

(8 citation statements)

References 24 publications

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“…Adalimumab has been shown to be effective and well tolerated in children with Crohn's disease (59,(72)(73)(74)(75) and is one of only two anti-TNF agents approved for use in paediatric Crohn's disease (the other being infliximab). The clinical efficacy and tolerability of adalimumab was investigated in the 12-month IMAgiNE I study -a pivotal trial in 192 children with paediatric Crohn's disease (59).…”

Section: Paediatric Crohn Sdiseasementioning

confidence: 99%

Adalimumab in the Treatment of Immune-Mediated Diseases

Lapadula

Marchesoni

Armuzzi³

et al. 2014

Int J Immunopathol Pharmacol

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Tumour necrosis factor (TNF) plays an important role in the pathogenesis of immune-mediated inflammatory diseases (IMIDs). TNF inhibition results in down-regulation of abnormal and progressive inflammatory processes, resulting in rapid and sustained clinical remission, improved quality of life and prevention of target organ damage. Adalimumab is the first fully human monoclonal antibody directed against TNF. In this article, we review the role and cost effectiveness of adalimumab in the treatment of IMIDs in adults and children. The efficacy and tolerability of adalimumab has been demonstrated in patients with a wide range of inflammatory conditions, leading to regulatory approval in rheumatoid arthritis (RA), psoriatic arthritis (PsA), plaque psoriasis, inflammatory bowel diseases (Crohn's disease, ulcerative colitis, paediatric Crohn's disease, and intestinal Beheet's disease), ankylosing spondylitis (AS), axial spondyloarthritis (SpA) and juvenile idiopathic arthritis. The major tolerability issues with adalimumab are class effects, such as injection site reactions and increased risk of infection and lymphoma. As with all anti-TNF agents, adalimumab is immunogenic, although less than infliximab, and some patients receiving long-term adalimumab will develop anti-drug antibodies, causing a loss of response. Comparisons of its clinical utility and cost effectiveness have shown it to be a valid treatment choice in a wide range of patients. Recent data from Italian economic studies show the cost effectiveness

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Section: Paediatric Crohn Sdiseasementioning

confidence: 99%

Adalimumab in the Treatment of Immune-Mediated Diseases

Lapadula

Marchesoni

Armuzzi³

et al. 2014

Int J Immunopathol Pharmacol

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“…Another possible explanatory factor is the percentage of patients in our study who were naïve to anti-TNF-a (75 %), which was much higher than those in other published studies. Other factors influencing the high response rate in our study may be the maintenance dose of 40 mg every 2 weeks used in all patients, regardless of bodyweight, a regimen very similar to that used in other studies (13,14,17).…”

Section: Discussionmentioning

confidence: 92%

“…It binds specifically to both soluble and transmembrane TNF-a and blocks its functionality (13). In pediatric clinical practice ADA is usually prescribed for patients who have lost response or developed intolerance to IFX (14).…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of adalimumab in the treatment of Crohn's disease in children

Navas-López¹,

Blasco‐Alonso

Girón-Fernández-Crehuet

et al. 2013

Rev. esp. enferm. dig.

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Objectives: to describe the efficacy and safety of adalimumab (ADA) in inducing clinical remission and reducing inflammation of intestinal mucosa in children with Crohn's disease (CD).Methods: we carried out a descriptive, observational study with all patients diagnosed with CD and treated with ADA between January 2007 and March 2013. Disease activity was determined using the Pediatric Crohn's Disease Activity Index (PCDAI), and the degree of mucosa inflammation by fecal calprotectin (FC).Results: sixteen patients were included. Mean age at diagnosis was 10.6 ± 2.5 years, with a mean age at start of ADA treatment of 12.4 ± 1.8 years, and a median of 1.4 years (IQR 0.5-3) duration from CD diagnosis to start of treatment. Twelve patients were naïve to anti-TNF-a. The PCDAI score at start of ADA treatment was significantly reduced at 12 weeks of follow-up (31.25 IQR 26.8-37.5 vs. 1.2 IQR 0.0-5.0; p = 0.001). Similarly, the FC level decreased at 12 weeks (749 µg/g IQR 514-898 vs. 126 µg/g IQR 67.7-239.2; p = 0.02). Surgery was performed in 4 patients. Adverse events were reported in 4 patients. One patient developed lymphoma at 4 years of ADA treatment in monotherapy.Conclusions: ADA has been shown to be effective in children with moderate-to-severe CD. Treatment benefits should be weighed against side effects. Multicenter longitudinal studies with longer follow-up periods are required to determine the true efficacy and safety of long-term ADA treatment.

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“…Results from this study demonstrate the high effectiveness of adalimumab in this series of patients (up to 100 % of cases at 12 weeks after therapy onset) as assessed by clinical and laboratory criteria (using activity indices), as well as by fecal calprotectin levels, an extremely sensitive marker for intestinal inflammation. One conclusion drawn by the authors is the potential influence of early drug use as compared to prior studies, and of the high proportion of anti-TNFa-naive patients included, a situation scarcely reported in the pediatric literature (8).…”

mentioning

confidence: 75%

New perspectives in the treatment of pediatric Crohn's disease

Martín-de-Carpi

2013

Rev. esp. enferm. dig.

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Long-term efficacy of adalimumab in Paediatric Crohn's disease patients naïve to other anti-TNF therapies

Cited by 22 publications

References 24 publications

Adalimumab in the Treatment of Immune-Mediated Diseases

Adalimumab in the Treatment of Immune-Mediated Diseases

Efficacy and safety of adalimumab in the treatment of Crohn's disease in children

New perspectives in the treatment of pediatric Crohn's disease

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