Crohn＇s disease （CD） is a chronic relapsing and remitting autoinflammatory disorder of the gastrointestinal tract that has many intestinal and extraintestinal complications. The purpose of treatment is long-term re...Crohn＇s disease （CD） is a chronic relapsing and remitting autoinflammatory disorder of the gastrointestinal tract that has many intestinal and extraintestinal complications. The purpose of treatment is long-term remission, reduction of complications, and improvement of patients＇ quality of life. In many cases, this can be quite challenging and it is necessary to have a well thought out management strategy. We present the case of a 38-year-old woman with fistulizing CD that manifested as diffuse abdominal pain and bloody diarrhea accompanied by arthralgia. In addition, there were ulcerative lesions surrounded by cutaneous inflammation and erythema on her extremities, indicative of pyoderma gangrenosum. The patient was treated with high doses of parenteral methylprednisolone without any improvement and was started on adalimumab. A positive response to adalimumab therapy was observed： after 2 mo of therapy, the ulcerative skin lesion healed completely and the enterogastric fistula was closed affcer 5 mo adalimumab treatment. Adalimumab might be a suitable initial as well as maintenance therapy in patients with complicated CD.展开更多
AIM: To evaluate the efficacy of adalimumab induction therapy in patients with ulcerative colitis who previously responded to infliximab and then lost response or became intolerant. METHODS: Ten patients with ulcerati...AIM: To evaluate the efficacy of adalimumab induction therapy in patients with ulcerative colitis who previously responded to infliximab and then lost response or became intolerant. METHODS: Ten patients with ulcerative colitis were enrolled in a 4-wk open-label trial. The patients received a loading dose of 160 mg adalimumab at wk 0 followed by 80 mg at wk 2. The primary efficacy measure was clinical improvement at wk 4, as defined by a decrease in clinical activity index (CAI) of more than 4. RESULTS: Four of 10 patients (40%) benefited from subsequent adalimumab therapy; one patient achieved remission (CAI < 4) and 3 had clinical improvement at wk 4. 6 patients had no response (60%); 2 of 6 (33.3%) subsequently underwent colectomy. This was accompanied by a decrease in median CRP concentration from 16.8 mg/mL at baseline to 3.85 mg/mL at wk 4, excluding two patients who underwent colectomy after two infusions of adalimumab. Among the 6 patients with severe colitis (CAI > 12) at baseline, none achieved remission and only one patient had clinical improvement at wk 4. CONCLUSION: The small advantage of adalimumab in patients with mild to moderate ulcerative colitis and lost response or intolerance to infliximab needs to be confirmed in randomised, double-blind, placebo- controlled trials.展开更多
克罗恩病（CD）是一个反复发作的累及全消化道黏膜的透壁性慢性炎症，大约有50%的患者在初次诊断后的20年里会出现肠道并发症，只有10%的病人可以有长期临床缓解［1］。在过去的10年中，抗 TNF -α药物奇迹般地改变了 CD 的治疗效果，...克罗恩病（CD）是一个反复发作的累及全消化道黏膜的透壁性慢性炎症，大约有50%的患者在初次诊断后的20年里会出现肠道并发症，只有10%的病人可以有长期临床缓解［1］。在过去的10年中，抗 TNF -α药物奇迹般地改变了 CD 的治疗效果，尤其是早期（新近诊断的 CD 病人，没有先前应用激素或免疫抑制剂的病史）应用在改善临床症状，无激素临床缓解，黏膜愈合，减少疾病并发症，降低住院和外科手术方面有令人瞩目的效果［2，3］，并可长期获益［4］。目前有越来越多的病人在使用这些药物治疗，由此带来的经济和安全性问题以及伴随的副作用引起了显著关注。展开更多
There is no radical cure for ankylosing spondylitis,a chronic inflammation in joint,till now.Tumor necrosis factor-alpha（TNF-α） inhibitors can block the cascade in inflammatory chain and improve clinical symptom.Am...There is no radical cure for ankylosing spondylitis,a chronic inflammation in joint,till now.Tumor necrosis factor-alpha（TNF-α） inhibitors can block the cascade in inflammatory chain and improve clinical symptom.Among these biological agents,three of them are marketed in China：etanercept,infliximab and adalimumab.Some of the research progresses between 2014 and 2016 are summarized including treatment application,side effects of drugs,and comprehensive research of TNF-α inhibitors.展开更多
文摘Crohn＇s disease （CD） is a chronic relapsing and remitting autoinflammatory disorder of the gastrointestinal tract that has many intestinal and extraintestinal complications. The purpose of treatment is long-term remission, reduction of complications, and improvement of patients＇ quality of life. In many cases, this can be quite challenging and it is necessary to have a well thought out management strategy. We present the case of a 38-year-old woman with fistulizing CD that manifested as diffuse abdominal pain and bloody diarrhea accompanied by arthralgia. In addition, there were ulcerative lesions surrounded by cutaneous inflammation and erythema on her extremities, indicative of pyoderma gangrenosum. The patient was treated with high doses of parenteral methylprednisolone without any improvement and was started on adalimumab. A positive response to adalimumab therapy was observed： after 2 mo of therapy, the ulcerative skin lesion healed completely and the enterogastric fistula was closed affcer 5 mo adalimumab treatment. Adalimumab might be a suitable initial as well as maintenance therapy in patients with complicated CD.
文摘AIM: To evaluate the efficacy of adalimumab induction therapy in patients with ulcerative colitis who previously responded to infliximab and then lost response or became intolerant. METHODS: Ten patients with ulcerative colitis were enrolled in a 4-wk open-label trial. The patients received a loading dose of 160 mg adalimumab at wk 0 followed by 80 mg at wk 2. The primary efficacy measure was clinical improvement at wk 4, as defined by a decrease in clinical activity index (CAI) of more than 4. RESULTS: Four of 10 patients (40%) benefited from subsequent adalimumab therapy; one patient achieved remission (CAI < 4) and 3 had clinical improvement at wk 4. 6 patients had no response (60%); 2 of 6 (33.3%) subsequently underwent colectomy. This was accompanied by a decrease in median CRP concentration from 16.8 mg/mL at baseline to 3.85 mg/mL at wk 4, excluding two patients who underwent colectomy after two infusions of adalimumab. Among the 6 patients with severe colitis (CAI > 12) at baseline, none achieved remission and only one patient had clinical improvement at wk 4. CONCLUSION: The small advantage of adalimumab in patients with mild to moderate ulcerative colitis and lost response or intolerance to infliximab needs to be confirmed in randomised, double-blind, placebo- controlled trials.
文摘克罗恩病（CD）是一个反复发作的累及全消化道黏膜的透壁性慢性炎症，大约有50%的患者在初次诊断后的20年里会出现肠道并发症，只有10%的病人可以有长期临床缓解［1］。在过去的10年中，抗 TNF -α药物奇迹般地改变了 CD 的治疗效果，尤其是早期（新近诊断的 CD 病人，没有先前应用激素或免疫抑制剂的病史）应用在改善临床症状，无激素临床缓解，黏膜愈合，减少疾病并发症，降低住院和外科手术方面有令人瞩目的效果［2，3］，并可长期获益［4］。目前有越来越多的病人在使用这些药物治疗，由此带来的经济和安全性问题以及伴随的副作用引起了显著关注。
文摘There is no radical cure for ankylosing spondylitis,a chronic inflammation in joint,till now.Tumor necrosis factor-alpha（TNF-α） inhibitors can block the cascade in inflammatory chain and improve clinical symptom.Among these biological agents,three of them are marketed in China：etanercept,infliximab and adalimumab.Some of the research progresses between 2014 and 2016 are summarized including treatment application,side effects of drugs,and comprehensive research of TNF-α inhibitors.
