Six year adalimumab efficacy in steroid-dependent Crohn's disease patients: A prospective single-center real life study

Dig Liver Dis. 2016 Nov;48(11):1314-1317. doi: 10.1016/j.dld.2016.07.019. Epub 2016 Aug 9.

Abstract

Background: Adalimumab is effective in the treatment of Crohn's disease. We have already reported data on the efficacy of adalimumab in 110 steroid-dependent patients. At the end of the study 90 patients (64.5%) maintained clinical remission.

Aims: To assess efficacy and safety of adalimumab after 6 years in patients of the original cohort who responded to treatment.

Methods: The present study is an extension of the published paper on 90/110 patients. We report results on clinical remission and safety of 6 year maintenance therapy with adalimumab.

Results: Of the original cohort 90 patients completed the study, 17 were lost to follow-up and 3 died. At the end of follow-up (74.16±10.3 months) 37/90 patients (41%) maintained clinical remission. Of these, 32 (86%) continued adalimumab and 5 (13%) discontinued treatment due to clinical remission and mucosal healing. Of the remaining 53/90 patients, 47 (52%) discontinued adalimumab due to clinical failure and 6 (7%) to adverse events. We obtained endoscopy data in 31/32 patients in clinical remission continuing adalimumab: 11 (36%) did not improve, 6 (19%) worsened, 14 (45%) improved. At univariable analysis no variables were related to treatment outcome.

Conclusions: This "real life" prospective study shows that adalimumab is a long-term effective and safe maintenance treatment in steroid-dependent Crohn's disease patients.

Keywords: Adalimumab; Crohn's disease; Inflammatory bowel disease; Long term therapy; Steroid dependency.

Publication types

  • Observational Study

MeSH terms

  • Adalimumab / administration & dosage*
  • Adalimumab / adverse effects
  • Adult
  • Anti-Inflammatory Agents / administration & dosage*
  • Anti-Inflammatory Agents / adverse effects
  • Crohn Disease / drug therapy*
  • Female
  • Humans
  • Italy
  • Kaplan-Meier Estimate
  • Maintenance Chemotherapy / methods*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Prospective Studies
  • Remission Induction
  • Steroids / adverse effects*
  • Steroids / therapeutic use
  • Treatment Outcome

Substances

  • Anti-Inflammatory Agents
  • Steroids
  • Adalimumab