Faculty Collaboration Database

Short-term response to adalimumab in childhood inflammatory bowel disease. Inflamm Bowel Dis 2008 Dec;14(12):1683-7

Date

07/12/2008

Pubmed ID

18618629

DOI

10.1002/ibd.20534

Scopus ID

2-s2.0-59849102115 (requires institutional sign-in at Scopus site)   35 Citations

Abstract

BACKGROUND: Adalimumab is effective for adults with moderate to severe Crohn's disease (CD). Data in children with inflammatory bowel disease (IBD) is sparse. We aim to evaluate pediatric IBD response to adalimumab.

METHODS: We conducted a retrospective chart review of pediatric IBD patients treated with adalimumab. We defined response as either a decrease in the disease activity index severity or remission after 3-6 months of treatment.

RESULTS: Ten patients were identified. Seven had CD, three had ulcerative colitis (UC). All had colonic disease and disease in either the esophagus, stomach, or duodenum. Eight patients initially responded to infliximab, 5 with CD and 3 with UC; 2 CD patients had incomplete data for evaluation. The mean and median times between initial infliximab and initial adalimumab were 29.5 and 24 months, respectively. Eight patients responded to adalimumab 40 mg or 80 mg biweekly, or 80 mg initial dose followed by 40 mg biweekly. The mean Pediatric Crohn's Disease Activity Index (PCDAI) in CD patients before and after adalimumab were 12 and 4.2, respectively (normal <or=10). The mean Lichtiger Colitis Activity Index (LCAI) in UC patients before and after adalimumab were 9 and 5.1, respectively (normal <10). Corticosteroids were weaned off in 4/7 patients at 1 to 10 months after initiation of adalimumab. One patient with CD and 1 patient with UC failed adalimumab, required surgery, and remained on corticosteroids.

CONCLUSIONS: Adalimumab is useful in pediatric IBD patients who become intolerant of infliximab.

Author List

Noe JD, Pfefferkorn M

Author

Joshua D. Noe MD Associate Dean, Professor in the Pediatrics department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adalimumab
Adolescent
Anti-Inflammatory Agents
Antibodies, Monoclonal
Antibodies, Monoclonal, Humanized
Child
Colitis, Ulcerative
Crohn Disease
Female
Follow-Up Studies
Humans
Infliximab
Male
Prognosis
Remission Induction
Retrospective Studies
Treatment Outcome
Tumor Necrosis Factor-alpha