Adalimumab induction and maintenance therapy for patients with ulcerative colitis previously treated with infliximab

Abstract

Background: The long-term efficacy of adalimumab in patients with ulcerative colitis is not well known.

Aim: To evaluate the short- and long-term outcomes of adalimumab in ulcerative colitis patients previously treated with infliximab.

Methods: Patients with active ulcerative colitis were treated with adalimumab after failure of other therapies including infliximab. Short-term clinical response and remission were assessed at weeks 4 and 12. The proportion of patients who continued on adalimumab and the proportion of patients who remained colectomy free were assessed over the long term.

Results: Clinical response at weeks 4 and 12 was achieved in 16 (53%) and 18 (60%) patients, respectively, and clinical remission was obtained in 3 (10%) and 8 (27%) patients, respectively. After a mean 48 weeks' follow-up, 15 patients (50%) continued on adalimumab. Six patients (20%) required colectomy. All patients who achieved clinical response at week 12 were colectomy free at long term.

Conclusions: Adalimumab was well tolerated and induced durable clinical response in many patients with otherwise medically refractory ulcerative colitis. Patients achieving clinical response at week 12 avoided colectomy over the long term.