Reinisch W, Haas T, Kaser A, Petritsch W, Vogelsang H, Feichtenschlager T, Novacek G, Siebert F, Tilg H, Knoflach P
Medizinische Universität Wien, Univ.-Klinik Innere Medizin III, Waehringer Guertel 18 - 20, 1090 Wien, Osterreich.
Z Gastroenterol. 2009 Apr;47(4):372-80. doi: 10.1055/s-0028-1109218. Epub 2009 Apr 8.
The advent of anti-TNF alpha antibodies has clearly improved the outcome of patients with Crohn's disease. With adalimumab, the first fully human, monoclonal anti-TNF alpha antibody, which can be administered subcutaneously by means of a pen, became available in 2007. In Europe adalimumab is approved for the treatment of severe, active Crohn's disease, in patients who have not responded despite a full and adequate course of therapy with a corticosteroid and/or an immunosuppressant; or who are intolerant to or have medical contraindications for such therapies. Adalimumab is clinically efficacious both in patients with Crohn's disease naïve to previous exposure to anti-TNF alpha antibodies and in those previously exposed with a rapid onset of action and a confirmed maintenance performance over 3 years. A reduction in the rate of hospitalisation and an improvement of health-related quality of life are associated with this treatment. The safety profile of adalimumab is comparable to those of other TNF alpha inhibitors. Due to low immunogenicity, allergic reactions are rare. A careful screening of patients before and during treatment with adalimumab is of key importance. The presented therapy guidelines based on existing evidence are aimed to assist in the efficient and safe use of adalimumab in the treatment of Crohn's disease.
抗TNFα抗体的出现显著改善了克罗恩病患者的治疗效果。2007年，首个可通过笔式注射器皮下给药的全人源单克隆抗TNFα抗体阿达木单抗问世。在欧洲，阿达木单抗被批准用于治疗重度活动性克罗恩病，适用于那些尽管接受了皮质类固醇和/或免疫抑制剂的充分治疗仍无反应的患者；或对这些疗法不耐受或有医学禁忌的患者。阿达木单抗对于既往未接触过抗TNFα抗体的克罗恩病患者以及既往有过接触的患者均具有临床疗效，起效迅速且已证实其维持疗效超过3年。这种治疗与住院率降低及健康相关生活质量改善相关。阿达木单抗的安全性与其他TNFα抑制剂相当。由于免疫原性低，过敏反应罕见。在使用阿达木单抗治疗前和治疗期间对患者进行仔细筛查至关重要。基于现有证据制定的本治疗指南旨在帮助在克罗恩病治疗中有效且安全地使用阿达木单抗。
