Details

Autor(en) / Beteiligte

• Greener, Tomer
• Boland, Karen
• Steinhart, A Hillary
• Silverberg, Mark S

Titel

The unfinished symphony: golimumab therapy for anti-TNF refractory Crohn's disease

Ist Teil von

• Journal of Crohn's and colitis, 2017-12

Ort / Verlag

England

Erscheinungsjahr

2017

Quelle

Oxford Journals 2020 Medicine

Beschreibungen/Notizen

• Golimumab is approved for the treatment of moderate-to-severely active ulcerative colitis. However, there have been no formal trials to date to assess its utility in Crohn's disease (CD). Our aim was to determine the efficacy and safety of golimumab in patients with anti-TNF refractory CD. Patients with CD treated with golimumab between 2010 and 2017 were included in a retrospective observational study. The vast majority of patients failed 2 anti-TNFs agents. Clinical response was defined as a significant reduction in symptoms and biochemical markers of CD, and no requirement for surgery or introduction of immune-suppressants. Forty-five patients were included, with a median follow-up of 22 months (interquartile range 12-34) following initiation of golimumab. Induction and maintenance regimens were generally higher than standard dosing with first month cumulative doses of 400 mg and above in 75% of the patients. Monthly maintenance doses 200 mg was administered in 52% of patients. Clinical response at 3 months was achieved in 35/45 (77.7%) patients. The cumulative probabilities that patients with an initial response maintained their clinical response for 12 and 36 months after introduction of golimumab were 81% and 64%, respectively. Endoscopic improvement and mucosal healing at 12 months was achieved in 73% and 47% of patients, respectively. This study demonstrates the efficacy of golimumab in anti-TNF refractory CD patients. Further studies should be performed in CD to formally assess the efficacy of golimumab in a randomized controlled trial and to establish the optimal dosing regimen.