Adalimumab for the treatment of Crohn's disease.

The advent of biologic therapy for Crohn's disease has revolutionized our approach to disease management and redefined our goals. Infliximab (Remicade), an intravenously delivered murine-chimeric monoclonal antibody against TNF-alpha was released in 1998 and shown to have significant benefits in patients with refractory luminal and fistulizing Crohn's disease. Since then other anti-TNF strategies have undergone investigation with variable results. Adalimumab (Humira), a self administered, subcutaneous, fully human monoclonal antibody against TNF-alpha represents the next generation of therapy. It has demonstrated efficacy for induction and maintenance of remission in patients with moderate-to-severe Crohn's in three large double-blind, placebo-controlled, randomized trials. In addition it has demonstrated steroid-sparing properties and the ability to reduce hospitalizations and improve quality of life. It is anticipated, given its clinical efficacy, its fully human nature, and the convenience of self administration that it will have a significant effect on the management of Crohn's disease.