Survey on the use of adalimumab as maintenance therapy in Crohn's disease in England and Ireland

Research output: Contribution to journalArticlepeer-review

Authors

  • Evangelos A Russo
  • James O Lindsay
  • Simon Campbell
  • Ailsa Hart
  • John Hamlin
  • Timothy Orchard
  • Naila Arebi
  • Jeremy Nightingale
  • Meron R Jacyna
  • Simon M Gabe
  • Marian O'Connor
  • Adrian W Harris
  • Colm O'Morain

Colleges, School and Institutes

External organisations

  • Hammersmith Hospital, London, UK.

Abstract

INTRODUCTION: Adalimumab is effective in inducing and maintaining response/remission in patients with Crohn's disease either naive to biological therapies or after secondary failure of infliximab.

AIM: To present the first 'real-life' survey data from England and Ireland on the use of adalimumab.

METHOD: A retrospective audit conducted through a web-based questionnaire in England/Ireland.

RESULTS: We analysed data on 61 patients (35 female, 26 male) with a median age of 33 years (range 17-71 years) and an average follow-up of 8 months. The maximal maintenance dose was 40 mg every other week in 84% of patients, 40 mg weekly in 13% and 80 mg weekly in 3%. Maintenance adalimumab achieved remission in 57% of patients. The ongoing response rate was 83.6%. An additional 8% had a secondary loss of response after an average of 8.4 months (range 2-17). Adverse effects were observed in 23% of patients: of which there was local pain in 29%, infection in 36%, headaches in 14%, leucopenia (on azathioprine) in 7%, a painful rash in 7% and serum-sickness-type reaction in 7%. Adverse events led to discontinuation in two patients.

CONCLUSION: This English/Irish audit shows an acceptable response/remission and safety profile of adalimumab in the treatment of Crohn's disease. In contrast to earlier data from Scotland, dose escalation was only observed in 16% of patients. The majority of responders were steroid-free at follow-up.

Details

Original languageEnglish
Pages (from-to)334-9
Number of pages6
JournalEuropean Journal of Gastroenterology & Hepatology
Volume22
Issue number3
Publication statusPublished - Mar 2010

Keywords

  • Adalimumab, Adolescent, Adult, Aged, Anti-Inflammatory Agents, Antibodies, Monoclonal, Antibodies, Monoclonal, Humanized, Crohn Disease, Drug Utilization Review, England, Female, Gastrointestinal Agents, Health Care Surveys, Humans, Internet, Ireland, Male, Middle Aged, Practice Patterns, Physicians', Remission Induction, Retrospective Studies, Steroids, Surveys and Questionnaires, Time Factors, Treatment Outcome, Young Adult, Journal Article, Multicenter Study