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Systematic review: the short-term and long-term efficacy of adalimumab following discontinuation of infliximab.

Abstract：

BACKGROUND:Therapy with adalimumab has been shown to be effective in Crohn's disease (CD) patients who have lost response or are intolerant to infliximab. AIM:To determine the efficacy of adalimumab in CD patients who discontinued infliximab through a systematic review. METHODS:Electronic searches of EMBASE and MEDLINE databases up to May 1, 2009, as well as abstracts from the AGA (2006-2008), ACG (2006-2007), UEGW (2006-2008) and CDDW (2006-2009) identified randomized-controlled trials (RCT) or open-labelled cohorts (OLC) evaluating the short-term and/or long-term efficacy of adalimumab in infliximab failures. The response rates for short-term (clinical response and remission at 4 weeks) and long-term (remission at 6 and 12 months) efficacy were considered. RESULTS:A total of 1810 CD patients were identified among the 15 studies (2 RCT and 13 OLC). The majority of studies evaluated CD patients who either lost response or were intolerable to infliximab, although five OLCs permitted patients refractory to infliximab. Short-term clinical response (n = 9 articles) ranged from 41% to 83%. Long-term clinical remission at 12 months (n = 8 articles) ranged from 19% to 68%. The occurrence of severe adverse events ranged from 0% to 19% and four patients died. CONCLUSIONS:Current RCT and OLC evidence suggest that adalimumab is an efficacious therapy for CD patients who discontinue infliximab.

journal_name

Aliment Pharmacol Ther

journal_title

Alimentary pharmacology & therapeutics

authors

Ma C,Panaccione R,Heitman SJ,Devlin SM,Ghosh S,Kaplan GG

doi

10.1111/j.1365-2036.2009.04101.x

subject

Has Abstract

pub_date

2009-11-15 00:00:00

pages

977-86

issue

10

eissn

0269-2813

issn

1365-2036

pii

APT4101

journal_volume

30

pub_type

杂志文章,评审

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