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Adalimumab in budesonide and methotrexate refractory collagenous colitis
Linköping University, Department of Clinical and Experimental Medicine, Gastroenterology and Hepatology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Endocrinology and Gastroenterology UHL.
Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center for Diagnostics, Department of Clinical Pathology and Clinical Genetics.
Linköping University, Department of Clinical and Experimental Medicine, Gastroenterology and Hepatology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Endocrinology and Gastroenterology UHL.
2012 (English)In: Scandinavian Journal of Gastroenterology, ISSN 0036-5521, E-ISSN 1502-7708, ISSN 0036-5521, Vol. 47, no 1, 59-63 p.Article in journal (Refereed) Published
Abstract [en]

Background. We described three patients with collagenous colitis (CC) who developed side effects or were refractory to both budesonide and methotrexate and were given adalimumab (ADA) as a third-line treatment. Method/Patients. Three patients (two women, mean age 45 years and one man, 74 years old) were included. Mean bowel movements per day per week were calculated and stool weight/24 h registered prior to and following ADA treatment. ADA was given in doses 160 mg s.c. (baseline), 80 mg (week 2) and 40 mg (week 4). Sigmoidoscopies with biopsies were performed at baseline and after 6 weeks to examine changes in histology. The Psychological General Well-Being Index (PGWBI) and Short Health Scale (SHS) were used at baseline and after 6 weeks. Results. The two female patients tolerated the treatment well. The male patient developed, despite clinical response, side effects (vomiting, abdominal pain) after 80 mg of ADA and the treatment was stopped as side effects reoccurred after rechallenge. The two women were in clinical remission at week 6 and the mean stool frequency per day decreased from mean 11 to 2. Mean stool weight/24 h changed from 600 to 185 g. The quality of life improved drastically in all patients. There were no consistent changes in histology. Conclusion. ADA seems effective in budesonide and methotrexate refractory CC and can be administrated to selected patients to achieve clinical remission, improve quality of life and possibly avoid colectomy. Further studies for induction and maintenance treatment should be conducted to confirm efficacy and examine safety issues, even in long term

Place, publisher, year, edition, pages
Informa Healthcare, 2012. Vol. 47, no 1, 59-63 p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-73436DOI: 10.3109/00365521.2011.639079ISI: 000298190400008OAI: oai:DiVA.org:liu-73436DiVA: diva2:472346
Available from: 2012-01-03 Created: 2012-01-03 Last updated: 2017-12-08

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Münch, AndreasIgnatova, SimoneStröm, Magnus

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Münch, AndreasIgnatova, SimoneStröm, Magnus
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Gastroenterology and HepatologyFaculty of Health SciencesDepartment of Endocrinology and Gastroenterology UHLDepartment of Clinical and Experimental MedicineDepartment of Clinical Pathology and Clinical Genetics
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Scandinavian Journal of Gastroenterology
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