Sparrow Miles P
a Inflammatory Bowel Disease Service, Department of Gastroenterology , The Alfred Hospital and Monash University , Melbourne , Australia.
Expert Opin Biol Ther. 2017 May;17(5):613-621. doi: 10.1080/14712598.2017.1309390. Epub 2017 Mar 28.
Active ulcerative colitis is associated with significant morbidity and impairment to quality of life. Adalimumab is a welcome addition to the therapeutic armamentarium for clinicians treating patients with moderate-severe ulcerative colitis refractory to conventional therapies, an indication with few prior treatment options. It offers the convenience of self-injection and is most appropriate for outpatients with moderate disease activity. Areas covered: This review briefly summarizes data from well-designed clinical trials and observational real-life studies that demonstrate the safety and efficacy of adalimumab in UC. Particular attention is paid to newer studies, including those with objective treatment endpoints and pharmacokinetic outcomes that incorporate a treat to target approach in inflammatory bowel disease. Expert opinion: Adalimumab is effective for the induction and maintenance of remission in patients with moderate-severe ulcerative colitis refractory to conventional therapies. At currently approved doses, it is most suitable for use in outpatients with moderate disease activity; higher doses may be required for patients with more severe disease. The convenience of self-injection will make it popular for remote patients and it may be an appropriate option in patients in whom monotherapy, rather than combination therapy with an immunomodulator, is preferred.
活动性溃疡性结肠炎与显著的发病率和生活质量受损相关。对于治疗对传统疗法难治的中重度溃疡性结肠炎患者的临床医生而言，阿达木单抗是治疗手段中的一项受欢迎的补充药物，此前针对该适应证的治疗选择很少。它提供了自我注射的便利，最适合疾病活动度为中度的门诊患者。涵盖领域：本综述简要总结了精心设计的临床试验和观察性真实世界研究的数据，这些数据证明了阿达木单抗在溃疡性结肠炎中的安全性和有效性。特别关注了更新的研究，包括那些具有客观治疗终点和药代动力学结果的研究，这些研究在炎症性肠病中采用了达标治疗方法。专家意见：阿达木单抗对传统疗法难治的中重度溃疡性结肠炎患者诱导和维持缓解有效。在目前批准的剂量下，它最适合疾病活动度为中度的门诊患者使用；病情更严重的患者可能需要更高剂量。自我注射的便利性将使其受到偏远地区患者的欢迎，对于倾向于单药治疗而非与免疫调节剂联合治疗的患者，它可能是一个合适的选择。
