| Theme |
How Do You Choose Treatment Strategies for IBD Patients with a Critical Situation? |
| Title |
Optimization of the Treatment Strategy for Loss of Response to Adalimumab in Patients with Crohn's Disease |
| Author |
Noriko Kamata |
Department of Gastroenterology, Osaka City University Graduate School of Medicine |
| Author |
Kenji Watanabe |
Department of Gastroenterology, Osaka City General Hospital |
| [ Summary ] |
Adalimumab (ADA) is a fully humanized anti‒TNFα agent that has been widely used for young patients with Crohn's disease (CD) in our institute because of its availability and flexibility for self‒injection. In case of suspected loss of response to ADA, the presence of the responsible active lesion should be confirmed by using imaging modalities, including endoscopy. After assessing the active responsible lesion, the contents of intensified or changed treatment should be decided according to the clinical background and process of treatment contents. Precise objective monitoring is also important for assessing the efficacy of the replacement treatment. The pharmacokinetic approach will optimize the treatment strategy for anti‒TNFα agent‒resistant CD cases. Scheduled and precise objective monitoring with, for example, endoscopy should be useful to optimize the personalized treatment strategy for such refractory CD cases. |