Dose de-escalation to adalimumab 40 mg every three weeks in patients with inflammatory bowel disease—A multicenter, retrospective, observational study

Abstract : BACKGROUND: Data about the outcomes after adalimumab dose de-escalation in inflammatory bowel disease (IBD) are scarce. OBJECTIVES: To assess the outcomes after adalimumab dose de-escalation, and to identify potential factors associated with failure. METHODS: Retrospective, observational study including all IBD patients who had undergone adalimumab dose de-escalation to 40 mg every three weeks across seven GETAID centers, between June 2011 and September 2017. Failure of adalimumab dose de-escalation was defined as the need for treatment re-escalation, discontinuation of adalimumab, or clinical, biochemical and/or morphologic disease relapse. RESULTS: Fifty-six patients were identified (n = 46 Crohn's disease, n = 10 ulcerative colitis). Median (IQR) duration of follow-up after adalimumab dose de-escalation was 15.9 (7.9-30.6) months. Adalimumab dose de-escalation was a failure in 21/56 (37.5%) patients and successful in 35/56 (62.5%) patients. Median (IQR) time until failure was 8.9 (4.6-15.6) months. At multivariate analysis, inactive disease at magnetic resonance imaging and/or endoscopy in the year before adalimumab dose de-escalation decreased the risk of failure with a factor five (P = 0.02). CONCLUSIONS: Adalimumab dose de-escalation to 40 mg every three weeks is possible in almost two thirds of IBD patients. Objective morphologic signs of active disease should be ruled out before considering a de-escalation strategy with adalimumab.
Liste complète des métadonnées

https://hal.umontpellier.fr/hal-02420202
Contributeur : Anthony Herrada <>
Soumis le : jeudi 19 décembre 2019 - 17:26:16
Dernière modification le : lundi 17 février 2020 - 17:32:53

Identifiants

Citation

Lieven Pouillon, Anne Lamoureux, Guillaume Pineton de Chambrun, Lucine Vuitton, Benjamin Pariente, et al.. Dose de-escalation to adalimumab 40 mg every three weeks in patients with inflammatory bowel disease—A multicenter, retrospective, observational study. Digestive and Liver Disease, WB Saunders, 2019, 51 (2), pp.236-241. ⟨10.1016/j.dld.2018.10.022⟩. ⟨hal-02420202⟩

Partager

Métriques

Consultations de la notice

41