Outcomes of limited period of adalimumab treatment in moderate to severe Crohn's disease patients: Taiwan Society of Inflammatory Bowel Disease Study
Intestinal Research
; : 487-494, 2017.
Article
in En
| WPRIM
| ID: wpr-197215
Responsible library:
WPRO
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.
Key words
Full text:
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Index:
WPRIM
Main subject:
Recurrence
/
Taiwan
/
Biological Products
/
Budgets
/
Inflammatory Bowel Diseases
/
Crohn Disease
/
Multivariate Analysis
/
Retrospective Studies
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Risk Factors
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Follow-Up Studies
Type of study:
Etiology_studies
/
Guideline
/
Health_economic_evaluation
/
Observational_studies
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Prognostic_studies
/
Risk_factors_studies
Limits:
Humans
/
Male
Country/Region as subject:
Asia
Language:
En
Journal:
Intestinal Research
Year:
2017
Type:
Article