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Short and long-term efficacy of adalimumab in ulcerative colitis : a real-life study

Angelison, Leif LU ; Almer, Sven ; Davidsdottir, Loa ; Hammarlund, Per ; Lindgren, Stefan LU ; Hindorf, Ulf LU ; Marsal, Jan LU and Hertervig, Erik LU (2020) In Scandinavian Journal of Gastroenterology
Abstract

Objective: Randomized controlled trials have shown the effectiveness of Adalimumab in ulcerative colitis. However, real-life data is scarce. We aimed to assess the effectiveness and predictive factors of effectiveness in a large Swedish cohort. Methods: Retrospective capture of data from local registries at five Swedish IBD centers. Clinical response and remission rates were assessed at three months after starting adalimumab treatment and patients were followed until colectomy or need for another biological. Bio-naive patients were compared to bio experienced patients. Factors associated with short term responses were assessed using logistic regression model. Failure on drug was assessed using a Cox proportional hazards regression... (More)

Objective: Randomized controlled trials have shown the effectiveness of Adalimumab in ulcerative colitis. However, real-life data is scarce. We aimed to assess the effectiveness and predictive factors of effectiveness in a large Swedish cohort. Methods: Retrospective capture of data from local registries at five Swedish IBD centers. Clinical response and remission rates were assessed at three months after starting adalimumab treatment and patients were followed until colectomy or need for another biological. Bio-naive patients were compared to bio experienced patients. Factors associated with short term responses were assessed using logistic regression model. Failure on drug was assessed using a Cox proportional hazards regression model. Results: 118 patients (59 males, 59 females) with median age 34.4 years (IQR 27.0–51.4) were included. Median disease duration was 4.3 years (IQR 2.0–9.0) and follow-up 1.27 years (IQR 0.33–4.1). A clinical corticosteroid-free remission was achieved by 38/118 (32.2%) and response by 91/118 (77%) after three months. CRP >3 mg/l at baseline was predictive of short-term failure to reach corticosteroid-free remission. Factors associated with survival on the drug were male gender, CRP <3 mg/l and absence of primary sclerosing cholangitis. Patients >42 years of age at diagnosis were more likely to respond to adalimumab and remain on treatment compared to patients <20 years. Conclusions: An elevated CRP-level, primary sclerosing cholangitis and female gender were predictors of treatment failure. In contrast older age at diagnosis was a predictor of short-term clinical response and drug survival. Prior infliximab failure, regardless of cause, did not influence the outcome of adalimumab treatment.

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author
organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
Adalimumab, predictors of response, real life study, ulcerative colitis
in
Scandinavian Journal of Gastroenterology
publisher
Taylor & Francis
external identifiers
  • scopus:85078416499
  • pmid:31961234
ISSN
0036-5521
DOI
10.1080/00365521.2020.1713210
language
English
LU publication?
yes
id
df026a9b-1d6d-4151-8cac-e869c8d41e9a
date added to LUP
2020-02-10 09:29:53
date last changed
2020-02-12 10:21:08
@article{df026a9b-1d6d-4151-8cac-e869c8d41e9a,
  abstract     = {<p>Objective: Randomized controlled trials have shown the effectiveness of Adalimumab in ulcerative colitis. However, real-life data is scarce. We aimed to assess the effectiveness and predictive factors of effectiveness in a large Swedish cohort. Methods: Retrospective capture of data from local registries at five Swedish IBD centers. Clinical response and remission rates were assessed at three months after starting adalimumab treatment and patients were followed until colectomy or need for another biological. Bio-naive patients were compared to bio experienced patients. Factors associated with short term responses were assessed using logistic regression model. Failure on drug was assessed using a Cox proportional hazards regression model. Results: 118 patients (59 males, 59 females) with median age 34.4 years (IQR 27.0–51.4) were included. Median disease duration was 4.3 years (IQR 2.0–9.0) and follow-up 1.27 years (IQR 0.33–4.1). A clinical corticosteroid-free remission was achieved by 38/118 (32.2%) and response by 91/118 (77%) after three months. CRP &gt;3 mg/l at baseline was predictive of short-term failure to reach corticosteroid-free remission. Factors associated with survival on the drug were male gender, CRP &lt;3 mg/l and absence of primary sclerosing cholangitis. Patients &gt;42 years of age at diagnosis were more likely to respond to adalimumab and remain on treatment compared to patients &lt;20 years. Conclusions: An elevated CRP-level, primary sclerosing cholangitis and female gender were predictors of treatment failure. In contrast older age at diagnosis was a predictor of short-term clinical response and drug survival. Prior infliximab failure, regardless of cause, did not influence the outcome of adalimumab treatment.</p>},
  author       = {Angelison, Leif and Almer, Sven and Davidsdottir, Loa and Hammarlund, Per and Lindgren, Stefan and Hindorf, Ulf and Marsal, Jan and Hertervig, Erik},
  issn         = {0036-5521},
  language     = {eng},
  month        = {01},
  publisher    = {Taylor & Francis},
  series       = {Scandinavian Journal of Gastroenterology},
  title        = {Short and long-term efficacy of adalimumab in ulcerative colitis : a real-life study},
  url          = {http://dx.doi.org/10.1080/00365521.2020.1713210},
  doi          = {10.1080/00365521.2020.1713210},
  year         = {2020},
}