Adalimumab An Effective Treatment Against Crohn’s Disease

Adalimumab

According to a study published in Gastroenterology, adalimumab, a TNF inhibitor, is effective in maintaining remission of Crohn’s disease in children. The study was conducted on 192 patients aged 6 to 17 years with moderate to severe Crohn’s disease. The researchers found that 80% of participants responded to treatment within the first month. Patients received, depending on body weight, whether a high dose of adalimumab (40 mg one week, then another week, 20mg) or low dose (20 mg one week, then another week, 10mg). Even if the results were not statistically significant, more patients in the high dose group were in remission at week 26. In terms of long-term response, 34% of patients were in clinical remission at 6 months and after one year 28% of patients were in remission.

Adalimumab

 Adalimumab (Humira) is a recombinant human monoclonal antibody that inhibits TNF-alpha, a cytokine with a role in the inflammatorys response and immune response. In other words adalimumab binds to TNF and prevents TNF binding to it s receptor. After treatment with adalimumab, there is a rapid decrease in levels of acute phase reactants (such as C-reactive protein), which is useful in inflammatory bowel diseases.Crohn’s disease and ulcerative colitis, also known as inflammatory bowel diseases, are diseases of the gastrointestinal tract without a precise cause.

Crohn’s disease typical features are giant cell granuloma sarcoid-like, discontinuous,transmural lesions and the presence of stenoses and fistulas in neighboring organs. In ulcerative colitis, lesions are continuous, located strictly to the colonic mucosa, and predominantly affecting the rectum and other segments of the colon without interesting other parts of the digestive tract. Differential diagnosis is made by histopathological  examination.

The most common symptoms are diarrhea, intestinal bleeding and abdominal pain. It can also occur weight loss, fatigue, fever, delays in development in children. Also inflammatory bowel diseases are associated with extraintestinal manifestation of such as arthritis, spondylitis, uveitis, erythema nodosum, sclerosing cholangitis, etc.

Modern medicine currently has no cure for inflammatory bowel diseases the treatment options only aim to control symptoms, reduce complications and improve quality of life. It should be noted, however,  that surgery may be curative in ulcerative colitis. Drugs used in inflammatory bowel diseases are derivatives of 5-aminosalicylates, corticosteroids, immunosuppressive agents (azathioprine, cyclosporine, methotrexate) and biological response modifying agents (infliximab, adalimumab). Of these, corticosteroids (prednisone) are not used to maintain remission due to their dangerous to kids side effects (delay in growth and development in children and others) Corticosteroid therapy is used  in acute episodes only for short periods.