Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc
Journal website http://www.jocmr.org

Case Report

Volume 7, Number 2, February 2015, pages 118-121

The First Case of Biological Therapy Discontinuation After a Complete Remission Induced by Maintenance Therapy With Adalimumab for Refractory Ulcerative Colitis

Figure

Figure 1.
Figure 1. Colonoscopy before (at 0 week) and at 32 weeks after induction and maintenance therapy with ADA (160/80/40 mg every other week). (A) The first colonoscopy reveals some ulcers with erythematous and edematous changes within the mucosa of the sigmoid and rectum. Mayo endoscopy subscore, 3 points. (B) Colonoscopy reveals mucosal healing with scars within the mucosa of the sigmoid colon following 32 weeks of treatment.

Table

Table 1. The Clinical Course of Mayo Scores and Eruption Severity With Concomitant Drugs’ Doses Including SASP, Prednisolone, and ADA
 
Times from ADA start (weeks) -2 0 2 4 8 32 52 78 104 124 130 176
#Partial Mayo scores without endoscopy subscore. -: none; +: mild; ++: moderate; +++: severe.
SASP (mg) 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500
Corticoteroids (mg) 10 10 10 10 10 0 0 0 0 0 0 0
ADA injections (mg) - 160 80 40 40 40 40 40 40 Discontinued - -
Mayo scores 9 6# 6 1 1 1 1 1# 1 1
Bowel movements (points) 3 3 3 1 1 1 1 1 1 1
Anal bleeding (points) 1 1 1 0 0 0 0 0 0 0
Endoscopic score (points) 3 1 0 0 0 0 0 0
Adverse events
Skin eruptions - - - - + ++ + +++ - -