Hiroki Tanaka1, Noriko Kamata2, Akihiro Yamada3, Katsuya Endo4, Toshimitsu Fujii5, Takuya Yoshino6,7, Takeshi Sugaya8, Yoko Yokoyama9, Shigeki Bamba10, Junji Umeno11, Yuka Yanai12, Manabu Ishii13, Takaaki Kawaguchi14, Shinichiro Shinzaki15, Yosuke Toya16, Taku Kobayashi17, Masanori Nojima18, Toshifumi Hibi17. 1. IBD Center, Sapporo Kosei General Hospital, Sapporo, Japan. 2. Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan. 3. Department of Internal Medicine, Toho University Sakura Medical Center, Sakura, Japan. 4. Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan. 5. Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University, Tokyo, Japan. 6. Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan. 7. IBD Center, Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka, Japan. 8. Department of Gastroenterology, Dokkyo Medical University, Mibu, Japan. 9. Division of Internal Medicine, Department of Inflammatory Bowel Disease, Hyogo College of Medicine, Nishinomiya, Japan. 10. Division of Gastroenterology, Shiga University of Medical Science, Shiga, Japan. 11. Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. 12. Department of Gastroenterology, Oita Red Cross Hospital, Oita, Japan. 13. Department of Internal Medicine, Division of Gastroenterology, Kawasaki Medical School, Kurashiki, Japan. 14. Department of Internal Medicine, Division of IBD, Tokyo Yamate Medical Center, Tokyo, Japan. 15. Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Suita, Japan. 16. Division of Gastroenterology, School of Medicine, Iwate Medical University, Morioka, Japan. 17. Center for Advanced IBD Research and Treatment, Kitasato University Kitasato Institute Hospital, Tokyo, Japan. 18. Center for Translational Research, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan.
Abstract
BACKGROUND AND AIM: There are few studies on the long-term efficacy of adalimumab treatment for patients with Crohn's disease. We have conducted a large, multicenter, retrospective cohort study to evaluate the long-term retention rate and prognostic factors associated with the discontinuation of adalimumab treatment in patients with Crohn's disease. METHODS: Data were collected from all patients with Crohn's disease who had received at least one induction dose of 160 mg of adalimumab between October 2010 and December 2013 at 41 institutions. The cumulative retention rates of adalimumab treatment following the first administration were estimated using the Kaplan-Meier method. Prognostic factors related to the cumulative retention rates were evaluated by log-rank tests and multivariate Cox regression analysis. RESULTS: A total of 1189 patients were included in the study. The 1-, 2-, 3-, and 4-year cumulative retention rates of adalimumab were 81%, 72%, 65%, and 62%, respectively. The multivariate Cox regression analysis confirmed female sex, previous infliximab use, perianal disease, concomitant treatment with prednisolone at baseline, higher C-reactive protein levels, and lower albumin levels as significant independent predictors of poor retention rate of adalimumab treatment. Significantly, more female patients than male patients discontinued adalimumab because of adverse events, especially skin reactions, infections, and arthralgia. CONCLUSIONS: Our data demonstrated a good retention rate of adalimumab in patients with Crohn's disease over a 4-year period. Female sex, perianal disease, concomitant treatment with prednisolone at baseline, previous infliximab use, higher C-reactive protein levels, and lower albumin levels were associated with poor retention of adalimumab treatment.
BACKGROUND AND AIM: There are few studies on the long-term efficacy of adalimumab treatment for patients with Crohn's disease. We have conducted a large, multicenter, retrospective cohort study to evaluate the long-term retention rate and prognostic factors associated with the discontinuation of adalimumab treatment in patients with Crohn's disease. METHODS: Data were collected from all patients with Crohn's disease who had received at least one induction dose of 160 mg of adalimumab between October 2010 and December 2013 at 41 institutions. The cumulative retention rates of adalimumab treatment following the first administration were estimated using the Kaplan-Meier method. Prognostic factors related to the cumulative retention rates were evaluated by log-rank tests and multivariate Cox regression analysis. RESULTS: A total of 1189 patients were included in the study. The 1-, 2-, 3-, and 4-year cumulative retention rates of adalimumab were 81%, 72%, 65%, and 62%, respectively. The multivariate Cox regression analysis confirmed female sex, previous infliximab use, perianal disease, concomitant treatment with prednisolone at baseline, higher C-reactive protein levels, and lower albumin levels as significant independent predictors of poor retention rate of adalimumab treatment. Significantly, more female patients than male patients discontinued adalimumab because of adverse events, especially skin reactions, infections, and arthralgia. CONCLUSIONS: Our data demonstrated a good retention rate of adalimumab in patients with Crohn's disease over a 4-year period. Female sex, perianal disease, concomitant treatment with prednisolone at baseline, previous infliximab use, higher C-reactive protein levels, and lower albumin levels were associated with poor retention of adalimumab treatment.
Authors: Bella Ungar; Zohar Ben-Shatach; Limor Selinger; Alona Malik; Ahmad Albshesh; Shomron Ben-Horin; Rami Eliakim; Uri Kopylov; Dan Carter Journal: United European Gastroenterol J Date: 2019-09-19 Impact factor: 4.623
Authors: Adam Krusiński; Anna Grzywa-Celińska; Katarzyna Szewczyk; Luiza Grzycka-Kowalczyk; Justyna Emeryk-Maksymiuk; Janusz Milanowski Journal: Int J Inflam Date: 2021-01-05