According to a story from Healio, a recent study found that a treatment combination of adalimumab and low dose methotrexate was able to reduce treatment failure by two times in pediatric cases of Crohn’s disease. Adalimumab is classified as a tumor necrosis factor (TNF) inhibitor, a class of drugs that is often central to treatment in this condition. Unfortunately, a major portion of patients experience non-response or loss of treatment response.
About Crohn’s Disease
Crohn’s disease is a form of inflammatory bowel disease which can impact any area of the digestive tract. The cause of the illness is not well understood, but a combination of environmental, genetic, bacterial, and immune system factors could play a role; smoking tobacco appears to increase risk. The disease is often identified in the teen years or early adulthood. While abnormal immune system behavior is also present, it is not considered an autoimmune disease. Symptoms include weight loss, abdominal distension, bowel obstruction, diarrhea, fever, abdominal pain, fatigue, and inflammation spreading to other areas (eyes, joints, etc.). Patients are at an elevated risk of cancer impacting the digestive tract. Treatment includes changes to diet, stopping smoking, steroids, immunosuppressants, and certain surgical operations. Symptoms tend to relapse and remit, and some patients are able to live mostly normal lives. However, there is no cure for Crohn’s disease and treatment must continue for life. Patients have a slightly reduced life expectancy. To learn more about Crohn’s disease, click here.
About The Study
297 patients were enrolled in the trial with 156 receiving a combination therapy and 141 receiving TNF inhibitor therapy on its own. Of the combination therapy cohort, 110 were treated with infliximab, another TNF inhibitor, and 46 received adalimumab. Of the monotherapy group, 39 were treated with adalimumab and 102 were treated with infliximab. Patients were monitored from 1-3 years.
The researchers found a two-fold decrease in instances of treatment failure in those using adalimumab plus methotrexate when compared to those using adalimumab on its own. In addition, it took longer for treatment failure to occur in the combination group. This effect was not found in the group using infliximab.
30% of the patients eventually saw treatment failure, including 27% of infliximab users and 36% of adalimumab users. Overall, the researchers concluded that children with Crohn’s disease should begin treatment with the adalimumab and methotrexate combination due to the reduced rate of treatment failure, excluding any potential contraindications.
