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首页> 外文期刊>Journal of Medical Case Reports >Adalimumab - an effective and promising treatment for patients with fistulizing Crohn's disease: a case series
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Adalimumab - an effective and promising treatment for patients with fistulizing Crohn's disease: a case series

机译：阿达木单抗-一种治疗克罗恩病的有效有效方法：病例系列

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Introduction Crohn's disease is a chronic inflammatory bowel disease of unknown etiology which may affect any part of the bowel. Fistulas are a common and often serious complication of Crohn's disease. The treatment for fistulizing Crohn's disease can be medical, surgical or a combination of the two. Recently, adalimumab, a fully human anti-tumor necrosis factor monoclonal antibody, has been suggested as a safe and effective treatment for the induction and maintenance of remission in adult patients with moderate to severe Crohn's disease, who are refractory to conventional therapy or intolerant to infliximab. However, large studies focusing on evaluating the efficacy of adalimumab in fistulizing Crohn's disease have not yet been published. Case presentation We report the cases of three patients, of European Caucasian ethnicity and Greek nationality, with active luminal and fistulizing Crohn's disease. All of the cases were treated successfully with adalimumab. Patient 1 (a 44-year-old man) and patient 2 (an 18-year-old woman) developed early post-surgical enterocutaneous fistulas, while patient 3 (a 20-year-old woman) had peri-anal fistulizing Crohn's disease. Adalimumab treatment (160 mg subcutaneously at week zero, 80 mg at week two, and 40 mg every other week) was used for three different indications: (1) after the failure of other conservative medical treatments for Crohn's disease (patient 1); (2) as a monotherapy in treating a naive patient (patient 2); (3) after an intolerance to infliximab (patient 3). A remission of the active luminal and fistulizing disease was achieved soon after the initiation of adalimumab and sustained thereafter with maintenance doses. No further surgical intervention was required and no adverse effects were observed in any of the cases. Conclusions Fistulizing Crohn's disease remains a challenge in clinical practice. Adalimumab seems to be an effective, well-tolerated and safe treatment option for the induction and maintenance of remission in patients with moderate to severe peri-anal fistulizing Crohn's disease. Furthermore, adalimumab seems to be a promising treatment option for patients with moderate to severe fistulizing Crohn's disease with enterocutaneous fistulas. However, this clinical observation needs to be investigated in further clinical trials.
机译：简介克罗恩病是一种病因不明的慢性炎症性肠病，可能会影响肠的任何部位。瘘管是克罗恩氏病的常见且通常是严重的并发症。瘘管克罗恩氏病的治疗可以是药物，外科手术或两者的结合。最近，已提出一种全人类抗肿瘤坏死因子单克隆抗体阿达木单抗作为一种安全有效的治疗方法，用于诱导和维持中度至重度克罗恩病的成人患者的缓解，这些患者对常规治疗是难治的或不能耐受英夫利昔单抗。然而，针对评估阿达木单抗治疗克罗恩病的疗效的大型研究尚未发表。病例介绍我们报告了3例欧洲白人和希腊裔患者，他们的管腔活动性和瘘管性克罗恩病患者的病例。所有病例均使用阿达木单抗成功治疗。患者1（44岁的男性）和患者2（18岁的女性）在手术后肠内皮肤瘘形成较早，而患者3（20岁的女性）则患有肛周瘘管克罗恩病。 。阿达木单抗治疗（第0周皮下注射160 mg，第2周皮下注射80 mg，隔周每隔40 mg）用于三种不同的适应症：（1）其他针对克罗恩病的保守治疗失败后（患者1）; （2）作为单一疗法治疗未治疗的患者（患者2）; （3）对英夫利昔单抗不耐受后（患者3）。阿达木单抗开始后不久，活动性管腔和瘘管疾病得以缓解，此后维持剂量维持。在任何情况下都不需要进一步的手术干预，也没有观察到不良反应。结论瘘管克罗恩病仍然是临床实践中的挑战。对于中度至重度肛周瘘管克罗恩病患者，诱导和维持缓解，阿达木单抗似乎是一种有效，耐受良好且安全的治疗选择。此外，阿达木单抗似乎是中度至重度瘘管合并克罗恩病并伴有肠内皮肤瘘的患者的有前途的治疗选择。但是，这种临床观察需要在进一步的临床试验中进行研究。

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