Adalimumab in ulcerative colitis – efficacy, safety and optimization in the era of treat-to target

ABSTRACT

Introduction: Active ulcerative colitis is associated with significant morbidity and impairment to quality of life. Adalimumab is a welcome addition to the therapeutic armamentarium for clinicians treating patients with moderate-severe ulcerative colitis refractory to conventional therapies, an indication with few prior treatment options. It offers the convenience of self-injection and is most appropriate for outpatients with moderate disease activity.

Areas covered: This review briefly summarizes data from well-designed clinical trials and observational real-life studies that demonstrate the safety and efficacy of adalimumab in UC. Particular attention is paid to newer studies, including those with objective treatment endpoints and pharmacokinetic outcomes that incorporate a treat to target approach in inflammatory bowel disease.

Expert opinion: Adalimumab is effective for the induction and maintenance of remission in patients with moderate-severe ulcerative colitis refractory to conventional therapies. At currently approved doses, it is most suitable for use in outpatients with moderate disease activity; higher doses may be required for patients with more severe disease. The convenience of self-injection will make it popular for remote patients and it may be an appropriate option in patients in whom monotherapy, rather than combination therapy with an immunomodulator, is preferred.

KEYWORDS:

• Adalimumab
• anti-tumor necrosis factor alpha agents
• biologic therapies
• inflammatory bowel disease
• treat to target
• ulcerative colitis

Declaration of interest

MP Sparrow is on advisory boards for Janssen Pharmaceuticals, AbbVie, Takeda, Hospira, Merck Sharp and Dohme and Celgene. He also has received speaker’s fees from Janssen Pharmaceuticals, AbbVie, Takeda and Hospira. He has no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

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Funding

This manuscript has not been funded.