Effectiveness of adalimumab for ulcerative colitis: A multicentre, retrospective study of clinical practice in Italy.


Journal

Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
ISSN: 1878-3562
Titre abrégé: Dig Liver Dis
Pays: Netherlands
ID NLM: 100958385

Informations de publication

Date de publication:
Mar 2022
Historique:
received: 05 06 2021
revised: 12 08 2021
accepted: 25 08 2021
pubmed: 21 9 2021
medline: 11 3 2022
entrez: 20 9 2021
Statut: ppublish

Résumé

Adalimumab is used to treat ulcerative colitis, but additional effectiveness and safety data are needed. This retrospective study considered adults with ulcerative colitis treated with adalimumab at 19 hospitals. Clinical data were collected from the start of treatment, after 2, 6 and 12 months, and at the last visit. Outcome measures of effectiveness were treatment duration, reasons for discontinuation and colectomy. We studied 381 patients treated with adalimumab for a median of 12.1 months. Disease activity at the start of treatment was moderate to severe in 262 cases (68.8%) and endoscopic activity was moderate to severe in 339 cases (89.0%). At week 8, clinical responses were observed in 177 cases (46.5%) and clinical remission in 136 cases (35.7%). At 12 months, remission was observed in 128 cases (33.6%). Overall, 44 patients required colectomy, and 170 patients (44.6%) were still taking adalimumab when data were collected. Variables associated with adalimumab discontinuation were concomitant steroid treatment, severe clinical-endoscopic activity at baseline, need for adalimumab intensification and drug-related adverse events. Variables associated with colectomy were concomitant steroid treatment and high baseline C-reactive protein. Adalimumab is safe and effective for the treatment of ulcerative colitis.

Sections du résumé

BACKGROUND BACKGROUND
Adalimumab is used to treat ulcerative colitis, but additional effectiveness and safety data are needed.
PATIENTS AND METHODS METHODS
This retrospective study considered adults with ulcerative colitis treated with adalimumab at 19 hospitals. Clinical data were collected from the start of treatment, after 2, 6 and 12 months, and at the last visit. Outcome measures of effectiveness were treatment duration, reasons for discontinuation and colectomy.
RESULTS RESULTS
We studied 381 patients treated with adalimumab for a median of 12.1 months. Disease activity at the start of treatment was moderate to severe in 262 cases (68.8%) and endoscopic activity was moderate to severe in 339 cases (89.0%). At week 8, clinical responses were observed in 177 cases (46.5%) and clinical remission in 136 cases (35.7%). At 12 months, remission was observed in 128 cases (33.6%). Overall, 44 patients required colectomy, and 170 patients (44.6%) were still taking adalimumab when data were collected. Variables associated with adalimumab discontinuation were concomitant steroid treatment, severe clinical-endoscopic activity at baseline, need for adalimumab intensification and drug-related adverse events. Variables associated with colectomy were concomitant steroid treatment and high baseline C-reactive protein.
CONCLUSION CONCLUSIONS
Adalimumab is safe and effective for the treatment of ulcerative colitis.

Identifiants

pubmed: 34538764
pii: S1590-8658(21)00761-1
doi: 10.1016/j.dld.2021.08.020
pii:
doi:

Substances chimiques

Tumor Necrosis Factor Inhibitors 0
Adalimumab FYS6T7F842

Types de publication

Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

352-357

Informations de copyright

Copyright © 2021. Published by Elsevier Ltd.

Déclaration de conflit d'intérêts

Conflict of Interest None declared.

Auteurs

Alessandro Vitello (A)

Gastroenterology Unit, Sant'Elia-Raimondi Hospital, Caltanissetta, Italy; Gastroenterology Unit, Mauriziano Hospital, Turin, Italy.

Mauro Grova (M)

IBD Unit, Internal Medicine, Villa Sofia-Cervello Hospitals, Palermo, Italy.

Daniela Pugliese (D)

Gastroenterology Unit, Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.

Fernando Rizzello (F)

DIMEC, Università di Bologna, IRCCS Azienda Ospedaliera Universitaria di Bologna, Bologna, Italy.

Francesco Lanzarotto (F)

Internal Medicine, Spedali Civili, Brescia, Italy.

Alessandro Lavagna (A)

Gastroenterology Unit, Mauriziano Hospital, Turin, Italy.

Roberta Caccaro (R)

Gastroenterology Unit, Padua University Hospital, Padua, Italy.

Maria Cappello (M)

Gastroenterology and Hepatology Section, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy.

Anna Viola (A)

IBD Unit, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.

Davide Giuseppe Ribaldone (DG)

Gastroenterology Unit, Città della Scienza e della Salute Hospital, Turin, Italy.

Mariabeatrice Principi (M)

Gastroenterology Unit, Bari University Hospital, Bari, Italy.

Elisa Stasi (E)

Gastroenterology Unit, Saverio De Bellis IRCCS Hospital, Castellana Grotte, Italy.

Maria Lia Scribano (ML)

Gastroenterology Unit, San Camillo Forlanini Hospital, Rome, Italy.

Marcello Maida (M)

Gastroenterology Unit, Sant'Elia-Raimondi Hospital, Caltanissetta, Italy.

Alessandra Soriano (A)

Gastroenterology Unit, Santa Maria Nuova Hospital, Reggio Emilia, Italy.

Cristina Bezzio (C)

Gastroenterology Unit, Di Circolo Hospital, Rho, Italy.

Giorgia Bodini (G)

Gastroenterology Unit, Department of Internal Medicine, IRCCS Policlinico San Martino, University of Genoa, Italy.

Filippo Mocciaro (F)

Gastroenterology and Endoscopy Unit, ARNAS Civico - Di Cristina - Benfratelli Hospital, Palermo, Italy.

Antonio Carlo Privitera (AC)

Gastroenterology Unit, Cannizzaro Hospital, Catania, Italy.

Daniele Simondi (D)

Gastroenterology Unit, Santa Croce e Carle Hospital, Cuneo, Italy.

Enrica Giuffrida (E)

Gastroenterology Unit, Mauriziano Hospital, Turin, Italy; Gastroenterology and Hepatology Section, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy.

Renata D'Incà (R)

Gastroenterology Unit, Padua University Hospital, Padua, Italy.

Chiara Ricci (C)

Internal Medicine, Spedali Civili, Brescia, Italy.

Paolo Gionchetti (P)

DIMEC, Università di Bologna, IRCCS Azienda Ospedaliera Universitaria di Bologna, Bologna, Italy.

Alessandro Armuzzi (A)

Gastroenterology Unit, Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.

Ambrogio Orlando (A)

IBD Unit, Internal Medicine, Villa Sofia-Cervello Hospitals, Palermo, Italy.

Marco Daperno (M)

Gastroenterology Unit, Mauriziano Hospital, Turin, Italy. Electronic address: mdaperno@gmail.com.

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