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Publications (2)4.1 Total impact

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    ABSTRACT: The tumor necrosis factor inhibitors infliximab and adalimumab are effective treatments for Crohn's disease (CD); however, some patients treated with infliximab experience a loss of efficacy. There is a lack of high-quality evidence available on whether adalimumab is an effective treatment for patients who have failed infliximab treatment. A systematic review was carried out to examine the efficacy and safety of adalimumab for the treatment of CD in patients who have failed infliximab treatment. PubMed, Google Scholar, and the Cochrane Library were searched using the terms 'adalimumab AND infliximab AND Crohn's'. Randomized-controlled trials and cohort studies were included if they involved patients treated with adalimumab after failing infliximab. Outcomes were response and remission rates, adverse event (AE) rate, and the rate of discontinuations because of AEs. Ten studies (one randomized-controlled trial and nine cohort studies) involving 1009 patients were included. Luminal disease remission rates ranged from 12 to 67% during induction and 29 to 72% during maintenance therapy. Fistulizing disease remission rates ranged from 5 to 50% during induction and 27 to 68% during maintenance therapy. Luminal disease response rates ranged from 29 to 83% during induction and 31 to 59% during maintenance therapy. Fistulizing disease response rates ranged from 15 to 44% during induction and 41 to 56% during maintenance therapy. The overall AE rate ranged from 13 to 69%. Most AEs were mild to moderate in severity. The rate of discontinuation because of AEs ranged from 0 to 14%. The findings reported in the current literature support adalimumab as an efficacious and safe treatment for CD in patients who have failed infliximab treatment.
    European journal of gastroenterology & hepatology 08/2013; 25(8):885-91. · 1.66 Impact Factor
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    ABSTRACT: INTRODUCTION: The authors performed a systematic review and meta-analysis of data from randomized controlled trials (RCTs) to evaluate the efficacy and safety of certolizumab pegol. METHODS: The authors searched PubMed, MEDLINE via Medscape, BioMed Central, Google Scholar, China National Knowledge Infrastructure (CNKI), the Cochrane library, and the Directory of Open Access Journals. The outcomes of interest were response and remission rates and the treatment-related toxicity rate. RESULTS: A total of five RCTs, involving 1,891 participants, were included. The meta-analysis revealed that certolizumab significantly increased the overall (induction + maintenance therapy) response [odds ratio (OR) 1.565, 95% CI 1.056-2.321, P = 0.026] and remission rates (OR 1.626, 95% CI 1.297-2.038, P < 0.001) compared with placebo. Certolizumab significantly increased the response and remission rates when given as maintenance therapy (OR 2.171, 95% CI 1.644-2.866, P < 0.001 and OR 1.888, 95% CI 1.390-2.565, P < 0.001), but not as induction therapy (OR 1.234, 95% CI 0.912-1.671, P = 0.173 and OR 1.361, 95% CI 0.974-1.901, P = 0.071). Certolizumab (induction + maintenance therapy) did not significantly increase the treatment-related toxicity rate compared with placebo (OR 0.985, 95% CI 0.799-1.214, P = 0.887). CONCLUSION: Certolizumab may be an efficacious treatment for Crohn's disease as maintenance therapy and appears to have a favorable safety profile.
    Advances in Therapy 05/2013; · 2.44 Impact Factor