Prevention of postoperative recurrence of Crohn's disease by Adalimumab: a case series

Eur J Gastroenterol Hepatol. 2012 Apr;24(4):468-70. doi: 10.1097/MEG.0b013e3283500849.

Abstract

Adalimumab, an anti-TNF-α monoclonal antibody, was found to be effective for the treatment of luminal Crohn's disease (CD), but its efficacy for the prevention of postoperative recurrence of CD is still unknown. Here, we present a case series of six patients who underwent resection for an ileocecal stricture caused by CD. Surgery removed the involved ileocolon, and pathology confirmed the presence of a fibrotic stricture. Two weeks after the operation, they were given Adalimumab at the dose of 160/80/40 mg every 2 weeks and were followed up. Since then, they have been disease-free for ≈ 3 years after surgery on clinical, radiological, and endoscopic/histological grounds (Crohn's Disease Activity Index ≤ 110 in all occasions). Up to now, they have had no anemia, no increase in inflammatory indices, and no abnormal blood tests. These are the first cases, to our knowledge, in which Adalimumab has been successfully used to prevent the postsurgical recurrence of CD, an event so far considered to be mandatory. Further large placebo-controlled studies are necessary to show the therapeutic advantage and the economic implications of these observations.

Publication types

  • Clinical Trial

MeSH terms

  • Adalimumab
  • Adult
  • Anti-Inflammatory Agents / administration & dosage
  • Anti-Inflammatory Agents / therapeutic use*
  • Antibodies, Monoclonal, Humanized / administration & dosage
  • Antibodies, Monoclonal, Humanized / therapeutic use*
  • Cecum / surgery
  • Combined Modality Therapy
  • Crohn Disease / prevention & control*
  • Crohn Disease / surgery
  • Drug Administration Schedule
  • Female
  • Humans
  • Ileum / surgery
  • Male
  • Middle Aged
  • Secondary Prevention
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors
  • Young Adult

Substances

  • Anti-Inflammatory Agents
  • Antibodies, Monoclonal, Humanized
  • Tumor Necrosis Factor-alpha
  • Adalimumab