Abstract:

Adalimumab, an antitumor necrosis factor monoclonal antibody, is effective in treating moderate-to-severely active Crohn’s disease. The purpose of our study is to determine clinical and endoscopic response during one-year Adalimumab therapy in Crohn’s disease.Materials and methods: We have included 17 patients with moderately active, azathioprine resistant Crohn’s disease; 9 of these patients had stenosis and 6 had fistulas. All of the patients were treated with Adalimumab. All of them were followed-up for 12 months. For evaluation of response to therapy we have used Crohn’s Disease Activity Index, C-reactive protein and hemoglobin.Results: At week 12 fourteen patients experienced clinical improvement (reduction in Crohn’s Disease Activity Index >100 points); all of the fistulas stopped draining. Significant improvement of anemia was observed after 12 months of Adalimumab therapy (p = 0.027), as well as complete endoscopic remission. Of all patients that were treated for 12 months, 3 experienced endoscopic relapse. Neither closure of fistulas was observed, nor were stenosing aeries improved during Adalimumab therapy.Conclusion: Achievement of endoscopic remission with biological therapy also leads to improvement in anemia. After one-year biological therapy endoscopic relapse can be observed. One year of Adalimumab therapy has diminished fistula draining but no closure was observed.