P343 Efficacy of adalimumab in mild-to-moderate inflammatory bowel disease: Real-life data from single-centre experience in the long-term period
F. Akyüz, A. Ormeci, N. Namazova, M. Guzel, A. Abbasgoulizadeh, L. Tahincioğlu, S. Alaskarlı, E. Gürel, E. Bilgin, A. Atasoy, B. Cavus, K. Demir, F. Besısık, S. Kaymakoğlu
Department of Gastroenterology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
Background
Adalimumab (ADA) is one of the most preferred anti-TNF agents because of its ease of use in real life. We aimed to evaluate the efficacy of ADA in the long-term period of inflammatory bowel disease (IBD) patients.
Methods
Patients treated with adalimumab (ADA) as the first- and second-line biological treatment for mild to moderate active IBD between January 2009 and March 2019 were included. The clinical and endoscopic response rate of ADA were evaluated, retrospectively. Remission was defined in ulcerative colitis patients (UC), if stool frequency ≤ 3/day with no bleeding and no mucosal lesions at the colonoscopy. Remission was defined in Crohn’s disease patients (CD) if CDAI < 150 and mucosal healing at the colonoscopy.
Results
Fifty-eight patients (81% Crohn’s disease, 58.6% biologic naive) were included in this study. Mean age was 41.4 ± 12.3 years old (19–67 years) and 46.6% of them were female. Median follow-up time was 57 months in UC and 65 months in Crohn’s disease (CD). Infliximab experience rate before ADA in UC and CD was 36.4%, 42.6%, respectively. CD’s related surgery rate was 43.5%; surgery rate 87.5% before ADA therapy and 12.5% after ADA treatment. Clinical and endoscopic remission rates were 81.8% / 63.6% and 89.4%/ 63.4 in UC and CD, respectively at the end of follow-up period. Loss of response rate was 20% in UC and 28.3% in CD (table). Mean months for loss of response were 42 ± 25.4 months and 29.7 ± 12 months in UC and CD, respectively. Clinical remission was obtained by dose escalation in 66% of CD patients who had response loss. Loss of response rate was not significantly different between IFX naive and IFX experienced patients (
| UC (11) | CD (47) | |
| Induction response (%) | 90.9 | 97.9 |
| Maintenance response (%) | 81.8 | 89.4 |
| Endoscopic response (%) | 63.6 | 63.4 |
| CRP, mg/dl (first) | 18.5 ± 17.07 | 12.6 ± 14 |
| CRP, mg/dl (last) | 9.2 ± 8.2 | 6.5 ± 10.7 |
| Biologic therapy after ADA (%) (IFX) | — | 4.3 |
| Biologic therapy after ADA (%) | 9.1 | 4.3 |
| Loss of response rate (%) | 20 | 28.3 |
Conclusion
In real life, the efficacy of ADA treatment is high in mild-to-moderate active IBD. Endoscopic remission was also acceptable for this group of patients.