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

• Published in: Digestion Vol. 90; no. 2; pp. 130 - 136
• Main Authors: Miyoshi, Jun, Hisamatsu, Tadakazu, Matsuoka, Katsuyoshi, Naganuma, Makoto, Maruyama, Yuriko, Yoneno, Kazuaki, Mori, Kiyoto, Kiyohara, Hiroki, Nanki, Kosaku, Okamoto, Susumu, Yajima, Tomoharu, Iwao, Yasushi, Ogata, Haruhiko, Hibi, Toshifumi, Kanai, Takanori
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland S. Karger AG 01.01.2014
• Subjects: Adalimumab; Adolescent; Adult; Aged; Anti-Inflammatory Agents - therapeutic use; Antibodies, Monoclonal, Humanized - therapeutic use; Crohn Disease - drug therapy; Early Medical Intervention; Female; Humans; Intestines - surgery; Male; Middle Aged; Original Paper; Prognosis; Remission Induction; Retrospective Studies; Treatment Outcome; Tumor Necrosis Factor-alpha - antagonists & inhibitors; Young Adult; Bowel resection; Anti-tumor necrosis factor antagonist; Clinical remission; Crohn's disease; Adalimumab
• ISSN: 0012-2823; 1421-9867
• DOI: 10.1159/000365783

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.