Adalimumab dose escalation is effective and well tolerated in Crohn's disease patients with secondary loss of response to adalimumab.

Abstract

BACKGROUND:

Although adalimumab is effective in Crohn's disease, most patients experience a loss of response over time. The aim of the present study was to evaluate efficacy and safety of adalimumab dose escalation and identify predictors of a clinical response in Crohn's disease patients with a secondary loss of response.

METHODS:

We performed a retrospective and observational study including all Crohn's disease patients who underwent dose escalation of adalimumab after a secondary loss of response from 2007 to 2015.

RESULTS:

A clinical response was observed in 99/124 (79%) patients at 3 months and in 62/107 (61%) patients at 12 months. The predictive factors of response to ADA dose escalation at 12 months on multivariate analysis were: maintenance therapy of 40mg every week rather than 80mg every other week (OR 3.64, 95% CI: 1.28-10.37) and a CRP level≤5mg/L at adalimumab dose escalation (OR 6.64, 95% CI: 1.40-27.53). Adalimumab was withdrawn in 4 patients due to side effects.

CONCLUSIONS:

Adalimumab dose escalation is an effective and well-tolerated therapeutic option in patients with secondary loss of response. A 40mg every week optimized regimen was predictive of a response to ADA dose escalation.

• Authors: Nicolas Duveau, Maria Nachury, Romain Gerard, Julien Branche, Vincent Maunoury, Medina Boualit, Pauline Wils, Pierre Desreumaux, Benjamin Pariente
• Journal: Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver (Dig Liver Dis) Vol. 49 Issue 2 Pg. 163-169 (Feb 2017) ISSN: 1878-3562 [Electronic] Netherlands
• PMID: 27899263 (Publication Type: Journal Article, Observational Study)
• Copyright: Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Chemical References

• Anti-Inflammatory Agents
• Adalimumab

Topics

• Adalimumab (administration & dosage)
• Adult
• Anti-Inflammatory Agents (administration & dosage)
• Crohn Disease (drug therapy)
• Dose-Response Relationship, Drug
• Drug Tolerance
• Female
• France
• Humans
• Kaplan-Meier Estimate
• Logistic Models
• Maintenance Chemotherapy
• Male
• Multivariate Analysis
• Remission Induction
• Retrospective Studies
• Time Factors
• Treatment Outcome