Adalimumab in Crohn's disease
Gert Van Assche1, Séverine Vermeire, Paul Rutgeerts
1Division of Gastroenterology, University of Leuven, Leuven, Belgium.
Biologics : Targets & Therapy
|August 27, 2009
Summary
Infliximab has advanced inflammatory bowel disease (IBD) treatment but lacks long-term data and can cause loss of response. New biologic agents, like adalimumab, show promise for Crohn's disease (CD) and ulcerative colitis (UC).
Area of Science:
- Gastroenterology
- Immunology
- Pharmacology
Background:
- Infliximab revolutionized inflammatory bowel diseases (IBD) treatment but doesn't offer a cure.
- Immunogenicity of infliximab correlates with secondary loss of response and intolerance.
- Long-term maintenance efficacy data for infliximab in ulcerative colitis (UC) are limited.
Purpose of the Study:
- To review novel biological agents for IBD treatment.
- To evaluate the efficacy and safety of adalimumab in Crohn's disease (CD) and UC.
- To compare the therapeutic potential of new agents with existing treatments.
Main Methods:
- Review of clinical trials and recent evidence on biological agents for IBD.
- Analysis of efficacy and safety data for anti-TNF agents, including adalimumab and certolizumab-pegol.
- Examination of regulatory approvals for adalimumab in CD.
Main Results:
- Adalimumab and certolizumab-pegol demonstrate maintenance efficacy in Crohn's disease (CD).
- Adalimumab is approved for moderate-to-severe luminal CD by FDA and EMEA.
- Further research is needed for adalimumab in fistulizing CD and UC.
Conclusions:
- Anti-TNF agents offer a positive benefit-to-risk ratio for refractory IBD.
- Adalimumab is expected to have a safety profile similar to infliximab, excluding infusion-related events.
- Novel biological agents represent a significant advancement in IBD management.
Related Concept Videos
01:24Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF
Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab (Humira),...
01:29Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents
Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel Disease...
01:21Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids
Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2 (COX-2),...
01:25Inflammatory Bowel Disease III: Crohn's Disease
Crohn’s disease is a chronic, relapsing form of inflammatory bowel disease characterized by segmental, transmural inflammation that can affect any part of the gastrointestinal tract. Its pathogenesis arises from a combination of genetic susceptibility, environmental exposures, epithelial barrier dysfunction, and immune dysregulation. Together, these factors lead to an exaggerated immune response against components of the gut microbiome.Genetic and Environmental InfluencesMultiple genetic...
01:30Inflammatory Bowel Disease II: Crohn's Disease
Introduction
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by transmural...
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by transmural...
01:29Inflammatory Bowel Disease IV: Pharmacological Management
Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
Pharmacologic...
Pharmacologic...