Pediatr Gastroenterol Hepatol Nutr.  2016 Jun;19(2):116-122. 10.5223/pghn.2016.19.2.116.

Adalimumab Treatment in Pediatric-Onset Crohn's Disease Patients after Infliximab Failure: A Single Center Study

Affiliations
  • 1Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. i101016@skku.edu

Abstract

PURPOSE
We aimed to investigate the efficacy and safety of adalimumab in pediatric-onset Crohn's disease patients who had failed treatment with infliximab.
METHODS
In this retrospective study, patients included were those who had been diagnosed with Crohn's disease before 18 years old, and had received treatment with adalimumab after infliximab failure. The efficacy of adalimumab treatment was investigated at 1 month and 1 year, and adverse events that had occurred during treatment with adalimumab were explored.
RESULTS
Ten patients were included in this study. The median duration from diagnosis to adalimumab treatment was 5.5 years (range: 2.4-7.9 years). At 1 month after adalimumab initiation, 80% (8/10) of patients showed clinical response, and 40% (4/10) achieved clinical remission. At 1 year, 71% (5/7) of patients showed clinical response, and 43% (3/7) were under clinical remission. Among the total included patients, 5 patients (50%) showed clinical response at 1 year. Primary non-response to adalimumab was observed in 2 patients (20%), and secondary failure to adalimumab was observed in 3 patients (30%) during 1 year treatment with adalimumab. No serious adverse event had occurred during adalimumab treatment.
CONCLUSION
Adalimumab was effective for 1 year without serious adverse events in half of pediatric-onset Crohn's disease patients who had failed treatment with infliximab.

Keyword

Pediatric Crohn's disease; Adalimumab; Antibody to infliximab

MeSH Terms

Adalimumab*
Crohn Disease*
Diagnosis
Humans
Infliximab*
Retrospective Studies
Adalimumab
Infliximab

Figure

  • Fig. 1 Schematic outline of clinical outcome during treatment with adalimumab. CD: Crohn's disease, ADA: adalimumab, IFX: infliximab.

  • Fig. 2 Clinical outcome between groups divided according to antibody to infliximab (ATI) status at infliximab cessation.


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