Adalimumab for Crohn Disease That Is Refractory to Infliximab

Adalimumab is a commercially available, entirely humanized, anti-tumor-necrosis–factor monoclonal antibody that is effective in inducing and maintaining remission in patients who have Crohn disease and no previous exposure to infliximab (Journal Watch Gastroenterology Mar 28 2006). However, whether adalimumab also is effective in patients who already have received infliximab is unknown.

In an industry-sponsored international study, 325 patients (age range, 18–75), who were either intolerant of infliximab or had responded to infliximab previously and then lost their response, were randomized to receive adalimumab (160 mg and 80 mg at week 0 and 2, respectively) or placebo. Participants were followed for 4 weeks.

Remission occurred in 21% of th…