Anti-tumor necrosis factor (TNF) agents have improved the care of Crohn's disease (CD).
After the first anti-TNF discontinuation, it is possible to switch to another anti-TNF.
There are 3 anti-TNF agents available for ulcerative colitis, but only 2 have been approved for CD because golimumab has not been studied for this indication.
Dr Martineau and colleagues examined the efficacy and safety of golimumab in CD.
Crohn's disease patients who received golimumab were identified in 12 French tertiary centers, and were retrospectively analyzed.
|There was clinical response in 56% of the patients after a mean duration of 4 months|
|Alimentary Pharmacology & Therapeutics|
The team's primary endpoint was the duration of golimumab treatment before escalation or discontinuation.
The clinical response was defined as a decrease of more than 3 points in the Harvey-Bradshaw index or by global physician assessment.
The researchers included 115 patients.
The golimumab treatment duration was 10 months, and 49% of the patients were still under treatment at the end of follow-up.
The research team observed clinical response in 56% of the patients after a mean duration of 4 months.
The probability of remaining under treatment without escalation at 6, 12 and 24 months was 55%, 35% and 19% respectively.
The research team noted that discontinuation of the first anti-TNF agent due to intolerance, and co-immunosuppression for more than 6 months were predictive factors of efficacy.
The team found that 6% of the patients discontinued treatment due to intolerance.
Dr Martineau's team concludes, "After failure of infliximab or adalimumab for Crohn's disease, golimumab was safe and seemed beneficial in half of the patients."