Background Adalimumab (ADA) and certolizumab pegol (CZP) have demonstrated efficacy in Crohn’s disease (CD) patients previously treated with infliximab (IFX).
Aim To assess the efficacy and tolerability of a third anti‐TNF in CD after failure of and/or intolerance to two different anti‐TNF antibodies.
Methods Crohn’s disease patients who received ADA or CZP after loss of response and/or intolerance to two anti‐TNF agent were included in this retrospective study. Data were collected using a standardized questionnaire. Clinical response, duration, safety and reasons for discontinuation were assessed.
Results Sixty‐seven patients treated with CZP (n = 40) or ADA (n = 27) were included. A clinical response was observed in 41 (61%) at week 6 and 34 patients (51%) at week 20. The probability of remaining under treatment at 3 months, 6 months and 9 months was 68%, 60% and 45%, respectively. At the end of follow‐up, the third anti‐TNF had been stopped in 36 patients for intolerance (n = 13), or failure (n = 23). Two deaths were observed.
Conclusions The treatment with a third anti‐TNF (CZP or ADA) agent of CD patients, who have experienced loss of response and/or intolerance to two anti‐TNF antibodies, has favourable short‐term and long‐term efficacy. It is an option to be considered in patients with no other therapeutic options.