Gastroenterologia y hepatologia · 2011
Adalimumab is effective in long-term real life clinical practice in both luminal and perianal Crohn's disease. The Madrid experience.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Fortea-Ormaechea José Ignacio, González-Lama Yago, Casis Begoña, Chaparro María, López Serrano Pilar, Van Domselaar Manuel, Bermejo Fernando, Pajares Ramón, Ponferrada Angel, Vera María Isabel, Martínez Montiel Pilar, Gisbert Javier P, Pérez-Calle José Luis, López San Román Antonio, Abreu Luis, Menchén Luis Alberto, Marín-Jiménez Ignacio
Аннотация
OBJECTIVE: To evaluate effectiveness and safety of adalimumab in CD patients of the Madrid area and identify predictors of response.
METHODS: Multicenter retrospective survey of all CD patients treated with adalimumab in 9 hospitals of the Madrid area (Spain). Univariate and multivariate analysis of predictors of response was performed.
RESULTS: 174 patients included (50% males) with a median follow-up of 40 weeks. 30% had active perianal fistulizing disease at the beginning of the therapy with adalimumab. 59% had been previously treated with infliximab, being the lost of response (42.2%) the most frequent cause of withdrawal of the drug. 33% of patients needed dose escalation from every-other week to every week. The median time for this dose escalation was 33 weeks (range 2-120). The percentages of complete response at 4 weeks, 6 months and end of follow-up were 63, 70 and 63% in luminal disease and 49, 50 and 41% in perianal disease respectively. The prevalence of adverse events was 18% (most frequent was: 5 abscesses) causing the withdrawal of the drug in 21% of them.
CONCLUSIONS: Adalimumab is effective and safe for the management of CD, even in refractory cases to infliximab.
METHODS: Multicenter retrospective survey of all CD patients treated with adalimumab in 9 hospitals of the Madrid area (Spain). Univariate and multivariate analysis of predictors of response was performed.
RESULTS: 174 patients included (50% males) with a median follow-up of 40 weeks. 30% had active perianal fistulizing disease at the beginning of the therapy with adalimumab. 59% had been previously treated with infliximab, being the lost of response (42.2%) the most frequent cause of withdrawal of the drug. 33% of patients needed dose escalation from every-other week to every week. The median time for this dose escalation was 33 weeks (range 2-120). The percentages of complete response at 4 weeks, 6 months and end of follow-up were 63, 70 and 63% in luminal disease and 49, 50 and 41% in perianal disease respectively. The prevalence of adverse events was 18% (most frequent was: 5 abscesses) causing the withdrawal of the drug in 21% of them.
CONCLUSIONS: Adalimumab is effective and safe for the management of CD, even in refractory cases to infliximab.
Предметные рубрики MeSH
AbscessAdalimumabAdultAntibodies, Monoclonal, HumanizedAzathioprineCombined Modality TherapyCrohn DiseaseCutaneous FistulaDose-Response Relationship, DrugDrug EvaluationDrug Therapy, CombinationFemaleFollow-Up StudiesHospitals, UrbanHumansImmunosuppressive AgentsMaleRectal FistulaRetrospective StudiesSmokingTumor Necrosis Factor-alpha