Assessing adherence to objective disease monitoring and outcomes with adalimumab in a real-world IBD cohort.
Dig Liver Dis
; 53(8): 980-986, 2021 Aug.
Article
en En
| MEDLINE
| ID: mdl-33640302
ABSTRACT
BACKGROUND:
Data suggests that tight objective monitoring may improve clinical outcomes in IBD.AIM:
To assess the adherence to serial tight objective monitoring(clinical and biomarkers) and its effect on clinical outcomes.METHODS:
We retrospectively reviewed the chart of 428 consecutive IBD patients started on adalimumab between January 1,2015-January 1,2019 [338 Crohn's disease(CD), 90 ulcerative colitis(UC)]. Clinical symptoms(assessed by Harvey-Bradshaw-Index,partial Mayo),C-Reactive Protein(CRP), and fecal calprotectin(FCAL) assessments were captured at treatment initiation and at 3,6,9, and12 months. Dose optimization and drug sustainability curves were plotted by Kaplan-Meier method.RESULTS:
Clinical evaluation was available in nearly all patients at 3(CD-UC95-94%), 6(90-83%), 9(86-85%) and 12(96-89%) months. CRP testing frequency decreased in CD patients over time. Compliance to serial FCAL testing was low. Clinical remission at one-year was higher in patients adherent to early assessment visit at 3 months(pâ¯=â¯0.001 for CD and UC). Adherence to early follow-up resulted in earlier dose optimization in CD and UC patients(pLogrank=0.026 for UC & pâ¯=â¯0.09 for CD). Overall drug sustainability did not differ.CONCLUSION:
Clinical & CRP, but not FCAL, were frequently assessed in patients starting adalimumab. Adherence to early objective combined follow-up visits resulted in earlier dose optimization, improved one-year clinical outcomes but did not change drug sustainability.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Colitis Ulcerosa
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Enfermedad de Crohn
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Monitoreo de Drogas
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Cumplimiento de la Medicación
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Adalimumab
Tipo de estudio:
Evaluation_studies
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Observational_studies
Límite:
Adolescent
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Adult
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Dig Liver Dis
Asunto de la revista:
GASTROENTEROLOGIA
Año:
2021
Tipo del documento:
Article
País de afiliación:
Estados Unidos