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KMID : 0988920170150040487
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Intestinal Research
2017 Volume.15 No. 4 p.487 ~ p.494
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Outcomes of limited period of adalimumab treatment in moderate to severe Crohn's disease patients: Taiwan Society of Inflammatory Bowel Disease Study
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Lin Wei Chen
Chou Jen Wei
Yen Hsu Heng
Hsu Wen Hung
Lin Hung Hsin
Lin Jen Kou
Chuang Chiao Hsiung
Huang Tien Yu
Wang Horng Yuan
Wei Shu Chen
Wong Jau Min
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Abstract
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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.
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KEYWORD
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Crohn disease, Adalimumab, Withdraw
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