BACKGROUND: Data for adalimumab in ulcerative colitis after prior use of infliximab are scarce. AIMS: To study adalimumab response rates and predictors of response in ulcerative colitis, including drug concentrations. METHODS: In this single centre cohort study 73 UC patients, previously exposed to infliximab, were assessed for response to adalimumab at weeks 12 and 52. Serum samples prior to week 12 were available and included in multivariate analysis to predict response. RESULTS: Overall clinical response at week 12 and 52 were 75% and 52%, respectively. Adalimumab was continued without need for dose escalation throughout year 1 in 16 patients, 22 needed dose escalation and 35 discontinued treatment within 1 year. Prior response to infliximab and early serum concentrations correlated with response. Receiver operator characteristic curve analysis yielded optimal adalimumab concentrations of 4.58 μg/mL for week 12 and 7.0 μg/mL for week 52. Independent predictors for response at week 12 were primary response to infliximab [odds ratio (OR) 8.33; 95% confidence interval (CI) 1.8-33.3; P = 0.006] and an adalimumab concentration ≥4.58 μg/mL at week 4 (OR 4.85; 95% CI 1.3-18.6; P = 0.009). Positive predictors for week 52 response were primary response to infliximab (OR 5.2; 95% CI 1.14-23.8; P = 0.034) and adalimumab concentration at week 4 of ≥7 μg/mL (OR 3.56; 95% CI 1.17-10.79; P = 0.025). CONCLUSION: Prior response to infliximab and high early adalimumab serum concentrations predict week 12 and year 1 responses to adalimumab in ulcerative colitis.
BACKGROUND: Data for adalimumab in ulcerative colitis after prior use of infliximab are scarce. AIMS: To study adalimumab response rates and predictors of response in ulcerative colitis, including drug concentrations. METHODS: In this single centre cohort study 73 UC patients, previously exposed to infliximab, were assessed for response to adalimumab at weeks 12 and 52. Serum samples prior to week 12 were available and included in multivariate analysis to predict response. RESULTS: Overall clinical response at week 12 and 52 were 75% and 52%, respectively. Adalimumab was continued without need for dose escalation throughout year 1 in 16 patients, 22 needed dose escalation and 35 discontinued treatment within 1 year. Prior response to infliximab and early serum concentrations correlated with response. Receiver operator characteristic curve analysis yielded optimal adalimumab concentrations of 4.58 μg/mL for week 12 and 7.0 μg/mL for week 52. Independent predictors for response at week 12 were primary response to infliximab [odds ratio (OR) 8.33; 95% confidence interval (CI) 1.8-33.3; P = 0.006] and an adalimumab concentration ≥4.58 μg/mL at week 4 (OR 4.85; 95% CI 1.3-18.6; P = 0.009). Positive predictors for week 52 response were primary response to infliximab (OR 5.2; 95% CI 1.14-23.8; P = 0.034) and adalimumab concentration at week 4 of ≥7 μg/mL (OR 3.56; 95% CI 1.17-10.79; P = 0.025). CONCLUSION: Prior response to infliximab and high early adalimumab serum concentrations predict week 12 and year 1 responses to adalimumab in ulcerative colitis.
Authors: Konstantinos Papamichael; Adam S Cheifetz; Gil Y Melmed; Peter M Irving; Niels Vande Casteele; Patricia L Kozuch; Laura E Raffals; Leonard Baidoo; Brian Bressler; Shane M Devlin; Jennifer Jones; Gilaad G Kaplan; Miles P Sparrow; Fernando S Velayos; Thomas Ullman; Corey A Siegel Journal: Clin Gastroenterol Hepatol Date: 2019-03-27 Impact factor: 11.382
Authors: Carlos Taxonera; Eva Iglesias; Fernando Muñoz; Marta Calvo; Manuel Barreiro-de Acosta; David Busquets; Xavier Calvet; Antonio Rodríguez; Ramón Pajares; Javier P Gisbert; Pilar López-Serrano; José Luís Pérez-Calle; Ángel Ponferrada; Cristóbal De la Coba; Fernando Bermejo; María Chaparro; David Olivares; Cristina Alba; Ignacio Fernández-Blanco Journal: Dig Dis Sci Date: 2016-12-19 Impact factor: 3.199
Authors: H Nakase; S Motoya; T Matsumoto; K Watanabe; T Hisamatsu; N Yoshimura; T Ishida; S Kato; T Nakagawa; M Esaki; M Nagahori; T Matsui; Y Naito; T Kanai; Y Suzuki; M Nojima; M Watanabe; T Hibi Journal: Aliment Pharmacol Ther Date: 2017-09-08 Impact factor: 8.171