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 Adalimumab was withdrawn in 4 patients due to side effects.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.
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 diseasepatients with a secondary loss of response. METHODS: We performed a retrospective and observational study including all Crohn's diseasepatients 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 Adalimumab was withdrawn in 4 patients due to side effects.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: Arne Carlsen; Roald Omdal; Kristian Øgreid Leitao; Kjetil Isaksen; Anne Kristine Hetta; Lars Normann Karlsen; Lars Aabakken; Nils Bolstad; David Warren; Knut E A Lundin; Tore Grimstad Journal: Therap Adv Gastroenterol Date: 2018-03-14 Impact factor: 4.409
Authors: Vito Annese; Rahul Nathwani; Maryam Alkhatry; Ahmad Al-Rifai; Sameer Al Awadhi; Filippos Georgopoulos; Ahmad N Jazzar; Ahmed M Khassouan; Zaher Koutoubi; Mazen S Taha; Jimmy K Limdi Journal: Therap Adv Gastroenterol Date: 2021-12-22 Impact factor: 4.409
Authors: Ashish Srinivasan; Robert Gilmore; Daniel van Langenberg; Peter De Cruz Journal: Therap Adv Gastroenterol Date: 2022-02-02 Impact factor: 4.409