Adalimumab - uma nova opção na doença de crohn?

H. T. Sousa*¹, F. Portela¹, P. Andrade¹, A. P. Pina², M. C. Leitão¹, D. Freitas¹

 

Resumo

Jovem de 15 anos portadora de doença de Crohn do cólon, não penetrante e não estenosante, com 1 ano de evolução. Trata-se de doente cortico-dependente e refractária à azatioprina, tendo a remissão sido obtida com infliximab, que foi descontinuado após reacção grave à 3ª infusão. Perante a reactivação da doença, apesar do tratamento com metotrexato e corticosteróides, obteve-se aprovação para o uso do adalimumab, conseguindo-se a redução do metotrexato, a suspensão da corticoterapia e a remissão clínica completa.

Este caso ilustra os resultados promissores recentemente apresentados sobre o uso do adalimumab na doença de Crohn e, em particular, a sua segurança em doentes intolerantes ou com perda de resposta ao infliximab. A este propósito, os autores fazem uma revisão da literatura sobre esta provável nova opção no tratamento da doença de Crohn.

 

Summary

Fifteen-year-old female with non stenotic and non fistulizing Crohn's colitis for one year. We report a steroid dependent and refractory to azathioprine patient, in whom disease remission was obtained with infliximab, which sought to be discontinued after severe acute reaction to third infusion. Treatment with steroids and methotrexate was established, but effective control of the disease was not achieved. We then obtained permission for the use of adalimumab, which allowed methotrexate reduction, steroid postponement and complete disease remission.

This case illustrates the recently presented promising results regarding the use of adalimumab on Crohn's disease, and on the particular setting of patients with intolerance or loss of response to infliximab. We briefly review the existing literature on this probable new therapeutic option for the treatment of Crohn's disease.

 

 

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Bibliografia

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*Correspondência:

Helena Tavares de Sousa

Serviço de Gastrenterologia

Hospitais da Universidade de Coimbra

3000-075 Coimbra - Portugal

Tel.: 239 400 483

e-mail: helenatsousa@netcabo.pt

 

(1) Serviço de Gastrenterologia.

(2) Serviço de Farmácia.

Hospitais da Universidade de Coimbra, Coimbra, Portugal.

Aceite para publicação: 22/06/2006