Adalimumab in ulcerative colitis - efficacy, safety and optimization in the era of treat-to target.
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.
a Inflammatory Bowel Disease Service, Department of Gastroenterology , The Alfred Hospital and Monash University , Melbourne , Australia.
Miles P
MP
Sparrow
D000068879:Adalimumab / Q000627:therapeutic use*; D000276:Adjuvants, Immunologic / Q000627:therapeutic use; D000818:Animals; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D002986:Clinical Trials as Topic / Q000379:methods; D003093:Colitis, Ulcerative / Q000175:diagnosis / Q000188:drug therapy*; D003131:Combined Modality Therapy / Q000379:methods; D016503:Drug Delivery Systems / Q000379:methods*; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D011788:Quality of Life; D016896:Treatment Outcome
D000276:Adjuvants, Immunologic; D000893:Anti-Inflammatory Agents; D007155:Immunologic Factors; D000068879:Adalimumab
Adalimumab; anti-tumor necrosis factor alpha agents; biologic therapies; inflammatory bowel disease; treat to target; ulcerative colitis