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Long-Term Outcomes of Adalimumab Treatment in 254 Patients with Crohn’s Disease: A Hospital-Based Cohort Study from Korea

Digestive Diseases and Sciences volume 62, pages 2882–2893 (2017)Cite this article

Abstract

Background and Aims

Large-scale studies regarding the long-term outcomes of adalimumab (ADA) treatment in Asian patients with Crohn’s disease (CD) are still scarce.

Methods

We retrospectively analyzed the long-term outcomes of ADA treatment in Korean CD patients who commenced on scheduled ADA treatment at Asan Medical Center between November 2008 and July 2016. Clinical response was defined as maintaining ADA treatment without dose intensification (DI) and/or major abdominal surgery (MAS).

Results

Of the 254 patients who received at least two doses of ADA at 2-week intervals as induction therapy, 250 patients (98.4%) showed an initial favorable response by week 4. Among responders, 243 patients were followed up for longer than 4 weeks and were included for further analysis. The median duration of ADA maintenance therapy was 19.4 months. At the last follow-up, 45 patients (18.5%) required DI after a median of 16.8 months and 31 (12.8%) required MAS after a median of 8.9 months. Finally, 161 patients (66.3%) were still receiving ADA without DI and/or MAS. The cumulative probability of maintaining ADA without DI and/or MAS was 81.1% at 1 year, and 36.5% at 5 years. Secondary loss of response to previous infliximab (P = 0.001) and elevated baseline C-reactive protein at starting ADA treatment (P = 0.008) were identified as independent predictors of a poor response to ADA treatment using multivariate regression analysis.

Conclusions

The long-term outcome of ADA treatment in a real-life cohort of Korean patients with CD appears to be comparable to that reported in previously published Western studies.

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Affiliations

  1. Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea

    Hyungil Seo, Byong Duk Ye, Eun Mi Song, Sun-Ho Lee, Kiju Chang, Sung Wook Hwang, Sang Hyoung Park, Dong-Hoon Yang, Kyung-Jo Kim, Jeong-Sik Byeon, Seung-Jae Myung & Suk-Kyun Yang

  2. Inflammatory Bowel Disease Center, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea

    Byong Duk Ye, Sung Wook Hwang, Sang Hyoung Park, Kyung-Jo Kim & Suk-Kyun Yang

  3. Health Screening and Promotion Center, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea

    Ho-Su Lee

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  1. Hyungil Seo
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Correspondence to Byong Duk Ye.

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Conflict of interest

Suk-Kyun Yang received a research Grant from Janssen Korea Ltd., but this Grant was not related to the topic of the current study. The remaining authors have no competing interests to declare.

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Supplementary Fig. 1

The cumulative probability of maintaining adalimumab therapy without dose intensification and/or major abdominal surgery stratified by previous exposure to infliximab (P = 0.014, the log-rank test). (TIFF 2731 kb)

Supplementary material 2 (DOCX 17 kb)

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Seo, H., Ye, B.D., Song, E.M. et al. Long-Term Outcomes of Adalimumab Treatment in 254 Patients with Crohn’s Disease: A Hospital-Based Cohort Study from Korea. Dig Dis Sci 62, 2882–2893 (2017). https://doi.org/10.1007/s10620-017-4715-7

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  • DOI: https://doi.org/10.1007/s10620-017-4715-7

Keywords

  • Crohn disease
  • Adalimumab
  • Treatment outcome
  • Korea