Article (Scientific journals)
Adalimumab dose escalation and dose de-escalation success rate and predictors in a large national cohort of Crohn's patients.
Baert, Filip; Glorieus, Elien; REENAERS, Catherine et al.
2013In Journal of Crohn's and Colitis, 7 (2)
Peer Reviewed verified by ORBi
 

Files


Full Text
2012-Adalimumab dose escalation... Crohn's patients-JCC-PostPE in press.pdf
Publisher postprint (470.42 kB)
Request a copy

All documents in ORBi are protected by a user license.

Send to



Details



Abstract :
[en] BACKGROUND AND AIMS: Adalimumab is efficacious in inducing and maintaining remission in Crohn's disease but dose escalation is needed in 30-40% after 1year. Attempts for dose de-escalation have not been studied. This study aimed to assess the need for, predictors, and outcome of dose escalation and de-escalation in a large cohort of adalimumab treated Crohn's patients. METHODS: All consecutive patients treated with open label adalimumab for active Crohn's disease from the participating centres were included in this cohort study. A detailed retrospective chart review was performed to look for possible factors predicting outcome. RESULTS: Eighty four percent of 720 patients had a primary response and were followed up for a median of 14months. Thirty four percent needed escalation after a median of 7months (0-55months). Multivariate predictors for dose escalation were the following: prior anti-TNF use (p<0.0001), no concomitant azathioprine or <3m (p<0.02) and abnormal CRP at start (p<0.05). Dose escalation re-induced response for at least 6months in 67%. Only abnormal CRP at start correlated with failure of dose escalation (p=0.02). Dose de-escalation was attempted in 54% and was successful in 63%. After a median follow-up of 14m adalimumab was discontinued in 29% of patients. CONCLUSION: In this study real life nationwide cohort of Crohn's patients treated with adalimumab dose escalation was needed in 34% and was successful in 67%. Dose de-escalation was attempted in 54% and was successful in 63%. Overall 71% of patients maintained long term response on adalimumab.
Disciplines :
Gastroenterology & hepatology
Author, co-author :
Baert, Filip
Glorieus, Elien
REENAERS, Catherine 
D'Haens, Geert
Peeters, Harald
Franchimont, Dennis
Dewit, Olivier
Caenepeel, Philippe
LOUIS, Edouard  ;  Centre Hospitalier Universitaire de Liège - CHU > Gastro-Entérologie-Hépatologie
Van Assche, Gert
Language :
English
Title :
Adalimumab dose escalation and dose de-escalation success rate and predictors in a large national cohort of Crohn's patients.
Publication date :
2013
Journal title :
Journal of Crohn's and Colitis
ISSN :
1873-9946
eISSN :
1876-4479
Publisher :
Elsevier, United Kingdom
Volume :
7
Issue :
2
Peer reviewed :
Peer Reviewed verified by ORBi
Commentary :
Copyright (c) 2012 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.
Available on ORBi :
since 05 February 2013

Statistics


Number of views
68 (6 by ULiège)
Number of downloads
2 (2 by ULiège)

Scopus citations®
 
91
Scopus citations®
without self-citations
85
OpenCitations
 
85

Bibliography


Similar publications



Contact ORBi