Effectiveness of infliximab after adalimumab failure in Crohn's disease

作     者：María Chaparro Montserrat Andreu Manuel Barreiro-de Acosta Esther García-Planella Elena Ricart Eugeni Domènech María Esteve Olga Merino Pilar Nos Mireia Pealva Javier P Gisbert 

作者机构：Department of GastroenterologyHospital Universitario de La PrincesaInstituto de Investigación Princesa(IP)and Centro de Investigación Biomédica en Red de Enfermedades Hepáticasy Digestivas(CIBEREHD)28006 MadridSpain Americio 17portal E 2℃28021 Madrid Department of GastroenterologyHospital del Mar Department of GastroenterologyHospital Clínico Universitario de Santiago Department of GastroenterologyHospital Santa Creui Sant Pau Department of GastroenterologyHospital ClínicBarcelonaand Centro de Investigación Biomédica en Red de Enfermedades Hepáticasy Digestivas Department of GastroenterologyHospital Germans Triasi Pujol and Centro de Investigación Biomédica en Red de Enfermedades Hepáticasy Digestivas(CIBEREHD) Department of GastroenterologyHospital Mutua de Terrassa Department of GastroenterologyHospital de Cruces Department of GastroenterologyHospital Universitario La Fe and Centro de Investigación Biomédica en Red de Enfermedades Hepáticasy Digestivas(CIBEREHD) Department of GastroenterologyHospital de Bellvitge Department of GastroenterologyHospital Universitario de La PrincesaInstituto de Investigación Princesa(IP)and Centro de Investigación Biomédica en Red de Enfermedades Hepáticasy Digestivas(CIBEREHD) 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2012年第18卷第37期

页      面：5219-5224页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：Adalimumab Biologics Crohn's disease In-fliximab Switch 

摘      要：AIM:To evaluate the effectiveness of infliximab as a second-line therapy in Crohn s disease patients after adalimumab failure. METHODS:A historical cohort study in a community-based gastroenterology practice evaluated Crohn s disease patients treated with infliximab (induction plus maintenance) after adalimumab failure. Patients were identified using a large Spanish database (ENEIDA). RESULTS:We included 15 Crohn s disease patients who received infliximab after adalimumab failure. Five patients discontinued adalimumab due to loss of response, 3 due to adverse events and 7 due to partial response. After infliximab therapy was started, all patients who had interrupted adalimumab due to loss of efficacy regained response. All patients who discontinued adalimumab due to adverse events responded to infliximab and maintained this response; one of these patients had an uneventful course on infliximab, but 2 developed adverse events. None of the 7 patients who interrupted adalimumab due to partial response reached remission with infliximab. CONCLUSION:Switching from adalimumab to infliximab may be useful in patients who develop adverse effects or loss of response, however, the benefit of infliximab in primary nonresponders was not established.