Outcomes of limited period of adalimumab treatment in moderate to severe Crohn's disease patients: Taiwan Society of Inflammatory Bowel Disease Study.
- Author:
Wei Chen LIN
1
;
Jen Wei CHOU
;
Hsu Heng YEN
;
Wen Hung HSU
;
Hung Hsin LIN
;
Jen Kou LIN
;
Chiao Hsiung CHUANG
;
Tien Yu HUANG
;
Horng Yuan WANG
;
Shu Chen WEI
;
Jau Min WONG
Author Information
- Publication Type:Multicenter Study ; Original Article
- Keywords: Crohn disease; Adalimumab; Withdraw
- MeSH: Adalimumab*; Anaphylaxis; Biological Products; Budgets; Crohn Disease*; Follow-Up Studies; Humans; Inflammatory Bowel Diseases*; Insurance; Male; Multivariate Analysis; National Health Programs; Observational Study; Recurrence; Retrospective Studies; Risk Factors; Taiwan*
- From:Intestinal Research 2017;15(4):487-494
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND/AIMS: In Taiwan, due to budget limitations, the National Health Insurance only allows for a limited period of biologics use in treating moderate to severe Crohn's disease (CD). We aimed to access the outcomes of CD patients following a limited period use of biologics, specifically focusing on the relapse rate and remission duration; also the response rate to second use when applicable. METHODS: This was a multicenter, retrospective, observational study and we enrolled CD patients who had been treated with adalimumab (ADA) according to the insurance guidelines from 2009 to 2015. RESULTS: A total of 54 CD patients, with follow-up of more than 6 months after the withdrawal of ADA, were enrolled. The average period of treatment with ADA was 16.7±9.7 months. After discontinuing ADA, 59.3% patients suffered a clinical relapse. In the univariate analysis, the reason for withdrawal was a risk factor for relapse (P=0.042). In the multivariate analysis, current smoker became an important risk factor for relapse (OR, 3.9; 95% CI, 1.2−14.8; P=0.044) and male sex was another risk factor (OR, 2.9; 95% CI, 1.1−8.6; P=0.049). For those 48 patients who received a second round of biologics, the clinical response was seen in 60.4%, and 1 anaphylaxis occurred. CONCLUSIONS: Fifty-nine percent of patients experienced a relapse after discontinuing the limited period of ADA treatment, and most of them occurred within 1 year following cessation. Male sex and current smoker were risk factors for relapse. Though 60.4% of the relapse patients responded to ADA again.
