Journal Article

Adalimumab for the prevention and/or treatment of post-operative recurrence of Crohn's disease: A prospective, two-year, single center, pilot study

Konstantinos Papamichael, Emmanuel Archavlis, Constantina Lariou and Gerassimos J. Mantzaris

in Journal of Crohn's and Colitis

Published on behalf of European Crohn's and Colitis Organisation

Volume 6, issue 9, pages 924-931
Published in print October 2012 | ISSN: 1873-9946
Published online October 2012 | e-ISSN: 1876-4479 | DOI: https://dx.doi.org/10.1016/j.crohns.2012.02.012
Adalimumab for the prevention and/or treatment of post-operative recurrence of Crohn's disease: A prospective, two-year, single center, pilot study

More Like This

Show all results sharing these subjects:

  • Medicine and Health
  • Clinical Medicine
  • Gastroenterology
  • Gastro-intestinal and Colorectal Surgery
  • Health, Illness, and Medicine

GO

Show Summary Details

Preview

Abstract

Background: Infliximab has shown efficacy at preventing post operative recurrence (POR) of Crohn's disease (CD). This study aimed at evaluating whether adalimumab can prevent and treat POR of CD.

Methods: This prospective, single-center, open-label, two-year study included 23 patients who had undergone ileocecal resection for refractory or complicated CD and were at high-risk for POR. Patients received adalimumab from post operative day 14 (Group I, n = 8) or at 6 months post operatively after confirmation of endoscopic recurrence (PO-ER) despite treatment with azathioprine, infliximab, or 5-ASA (patients intolerant to infliximab and azathioprine, Group II, n = 15). Symptom assessment and laboratory tests were performed at monthly visits. Endoscopic findings were graded using the Rutgeerts score (RS) at 6 and 24 months after initiation of adalimumab. Primary end-points were maintenance (group I) or achievement of mucosal healing (Group II). Secondary end-points were prevention of post operative clinical recurrence (PO-CR) (Group I) and endoscopic and clinical improvement (group II).

Results: In Group I, PO-ER (RS ≥ i2) was seen in one patient at 6 months PO, whereas a second patient developed PO-ER and PO-CR after 24 months of treatment. In Group II, all patients had PO-ER whereas 9 (60%) patients had PO-CR at study enrolment; after 24 months of treatment 9/15 (60%) patients achieved complete (RS-i0, n = 3) or near complete (RS-i1, n = 6) mucosal healing and 5/9 (56%) clinical remission. No serious adverse events were reported.

Conclusions: This pilot study suggests that adalimumab may prevent PO-ER and treat PO-ER/CR in high risk patients for POR of CD.

Keywords: Adalimumab; Infliximab; Crohn's disease; Post-operative recurrence

Journal Article.  4899 words.  Illustrated.

Subjects: Medicine and Health ; Clinical Medicine ; Gastroenterology ; Gastro-intestinal and Colorectal Surgery ; Health, Illness, and Medicine

Full text: subscription required

How to subscribe Recommend to my Librarian

Users without a subscription are not able to see the full content. Please, subscribe or login to access all content. subscribe or login to access all content.