BACKGROUND: Adalimumab is effective for the induction and maintenance of remission in Crohn's disease (CD)-patients. AIM: To find predictors for adalimumab dose escalation at initiation of adalimumab. METHODS: Crohn's disease patients in a single tertiary referral centre who started adalimumab between July 2007 and March 2010 at an induction dose (week 0 160 mg subcutaneously (sc), week 2 80 mg sc) and maintenance dose of 40 mg sc thereafter every other week were followed prospectively. Patients on adalimumab for at least 3 months were included. The number of patients needing dose escalation was assessed. Patients that needed dose escalation were compared with patients that did not need dose escalation. RESULTS: Of 199 CD patients treated with adalimumab and followed prospectively, 122 patients (M/F 54/68, median age 35 years, range 18-66 years, median CDAI 164, range 6-468) were treated for 3 months. In total 38% of these patients (46/122) needed a dose escalation within a median time of 21 weeks after adalimumab introduction (range 4-105). Body mass index (BMI) (P < 0.03) and secondary non-response to infliximab (IFX) (P < 0.06) were identified as predictors for dose escalation. Concomitant use of immunomodulators at initiation of adalimumab and the presence of autoantibodies to IFX did not predict dose escalation. CONCLUSIONS: Over one-third adalimumab-treated patients are dose escalated within a median of 5 months. Higher BMI and secondary non-response to IFX treatment are predictive for a dose escalation during adalimumab treatment.
BACKGROUND:Adalimumab is effective for the induction and maintenance of remission in Crohn's disease (CD)-patients. AIM: To find predictors for adalimumab dose escalation at initiation of adalimumab. METHODS:Crohn's diseasepatients in a single tertiary referral centre who started adalimumab between July 2007 and March 2010 at an induction dose (week 0 160 mg subcutaneously (sc), week 2 80 mg sc) and maintenance dose of 40 mg sc thereafter every other week were followed prospectively. Patients on adalimumab for at least 3 months were included. The number of patients needing dose escalation was assessed. Patients that needed dose escalation were compared with patients that did not need dose escalation. RESULTS: Of 199 CDpatients treated with adalimumab and followed prospectively, 122 patients (M/F 54/68, median age 35 years, range 18-66 years, median CDAI 164, range 6-468) were treated for 3 months. In total 38% of these patients (46/122) needed a dose escalation within a median time of 21 weeks after adalimumab introduction (range 4-105). Body mass index (BMI) (P < 0.03) and secondary non-response to infliximab (IFX) (P < 0.06) were identified as predictors for dose escalation. Concomitant use of immunomodulators at initiation of adalimumab and the presence of autoantibodies to IFX did not predict dose escalation. CONCLUSIONS: Over one-third adalimumab-treated patients are dose escalated within a median of 5 months. Higher BMI and secondary non-response to IFX treatment are predictive for a dose escalation during adalimumab treatment.
Authors: Charles W Randall; John A Vizuete; Nicholas Martinez; John J Alvarez; Karthik V Garapati; Mazyar Malakouti; Carlo M Taboada Journal: Therap Adv Gastroenterol Date: 2015-05 Impact factor: 4.409
Authors: E G Quetglas; A Armuzzi; S Wigge; G Fiorino; L Barnscheid; M Froelich; Silvio Danese Journal: Eur J Clin Pharmacol Date: 2015-05-27 Impact factor: 2.953
Authors: S Kurnool; N H Nguyen; J Proudfoot; P S Dulai; B S Boland; N Vande Casteele; E Evans; E L Grunvald; A Zarrinpar; W J Sandborn; S Singh Journal: Aliment Pharmacol Ther Date: 2018-04-17 Impact factor: 8.171