Adalimumab versus azathioprine to halt the progression of bowel damage in Crohn's disease: application of Lémann Index.
Scand J Gastroenterol
; 54(11): 1339-1345, 2019 Nov.
Article
em En
| MEDLINE
| ID: mdl-31692395
ABSTRACT
Background:
The Lémann Index (LI) was recently developed to evaluate the cumulative bowel damage in patients with Crohn's disease (CD).Aims:
To search for a difference between adalimumab and azathioprine to halt the progression of bowel damage in active CD, using the LI.Methods:
A single-centre, retrospective study was conducted. Patients with CD were included if they had colonoscopy and magnetic resonance enterography performed within 4 months from the start of adalimumab or azathioprine and repeated after 12 months of therapy. Primary outcome was reached if the increase of LI after 12 months of treatment was <0.3, the drug was not stopped, and the use of systemic steroids was continued for no more than 3 months.Results:
Ninety-one patients were enrolled, 31 (34.1%) of them treated with adalimumab and 60 (65.9%) with azathioprine. Sixty-seven percent of patients treated with adalimumab reached the primary outcome compared to 28.3% of patients treated with azathioprine (p = .0006). The LI in the group on adalimumab therapy decreased after 12 months (from 9.9 to 8.8), while in the group on azathioprine therapy it increased (from 7.7 to 8.8).Conclusion:
Treatment with adalimumab halts the progression of bowel damage in CD while that with azathioprine does not.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Azatioprina
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Doença de Crohn
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Adalimumab
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Imunossupressores
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Anti-Inflamatórios
Tipo de estudo:
Observational_studies
Limite:
Adolescent
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Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article