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Early Intervention with Adalimumab May Contribute to Favorable Clinical Efficacy in Patients with Crohn's Disease

Authors :
Kosaku Nanki
Kazuaki Yoneno
Makoto Naganuma
Yuriko Maruyama
Katsuyoshi Matsuoka
Takanori Kanai
Haruhiko Ogata
Tomoharu Yajima
Susumu Okamoto
Tadakazu Hisamatsu
Yasushi Iwao
Jun Miyoshi
Kiyoto Mori
Toshifumi Hibi
Hiroki Kiyohara
Source :
Digestion. 90:130-136
Publication Year :
2014
Publisher :
S. Karger AG, 2014.

Abstract

Background: We evaluated the clinical efficacy of adalimumab (ADA) for Crohn's disease (CD) and analyzed predictive factors for clinical remission and long-term prognosis. Methods: We retrospectively reviewed the medical records of 45 patients treated with ADA for CD at Keio University Hospital between October 2010 and March 2014. Clinical remission was defined as a Harvey-Bradshaw index of ≤4. Results: Twenty-eight of 45 patients (62.2%) achieved clinical remission at week 4. Among these 28 patients, 18 patients (64.3%) maintained clinical remission at week 26, and among these, 16 patients (88.9%) maintained clinical remission at week 52. Absence of a history of bowel resection and absence of prior anti-tumor necrosis factor (anti-TNF) therapy were significant predictive factors for clinical remission at week 4 upon multivariate logistic regression analyses. Younger age and a disease duration of ≤3 years correlated with clinical remission at week 26 upon univariate analyses. Patients without a history of bowel resection showed significantly better long-term prognosis than those with a history of bowel resection (p = 0.01). None of the patients contracted a serious infectious disease. Conclusions: Younger age, shorter duration of disease, being naive to anti-TNF antagonists, and absence of a history of bowel resection were associated with the efficacy of ADA in CD patients.

Details

ISSN :
14219867 and 00122823
Volume :
90
Database :
OpenAIRE
Journal :
Digestion
Accession number :
edsair.doi.dedup.....d31067712125d53570ca628f5275c506
Full Text :
https://doi.org/10.1159/000365783