Assessing adherence to objective disease monitoring and outcomes with adalimumab in a real-world IBD cohort: Al Khoury et al. Real-world tight monitoring with adalimumab

A. Al Khoury, Y. Xiao, P. A. Golovics, R. Kohen, W. Afif, G. Wild, G. Friedman, P. Galiatsatos, N. Hilzenrat, A. Szilagyi, J. Wyse, A. Cohen, A. Bitton, T. Bessissow, P. L. Lakatos

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Data suggests that tight objective monitoring may improve clinical outcomes in IBD. Aim: To assess the adherence to serial tight objective monitoring(clinical and biomarkers) and its effect on clinical outcomes. Methods: We retrospectively reviewed the chart of 428 consecutive IBD patients started on adalimumab between January 1,2015–January 1,2019 [338 Crohn's disease(CD), 90 ulcerative colitis(UC)]. Clinical symptoms(assessed by Harvey-Bradshaw-Index,partial Mayo),C-Reactive Protein(CRP), and fecal calprotectin(FCAL) assessments were captured at treatment initiation and at 3,6,9, and12 months. Dose optimization and drug sustainability curves were plotted by Kaplan-Meier method. Results: Clinical evaluation was available in nearly all patients at 3(CD-UC:95–94%), 6(90–83%), 9(86–85%) and 12(96–89%) months. CRP testing frequency decreased in CD patients over time. Compliance to serial FCAL testing was low. Clinical remission at one-year was higher in patients adherent to early assessment visit at 3 months(p = 0.001 for CD and UC). Adherence to early follow-up resulted in earlier dose optimization in CD and UC patients(pLogrank=0.026 for UC & p = 0.09 for CD). Overall drug sustainability did not differ. Conclusion: Clinical & CRP, but not FCAL, were frequently assessed in patients starting adalimumab. Adherence to early objective combined follow-up visits resulted in earlier dose optimization, improved one-year clinical outcomes but did not change drug sustainability.

Original languageEnglish
Pages (from-to)980-986
Number of pages7
JournalDigestive and Liver Disease
Volume53
Issue number8
DOIs
StatePublished - 1 Aug 2021
Externally publishedYes

Keywords

  • Adalimumab
  • Biomarker
  • Crohn's disease
  • Fecal calprotectin
  • Monitoring
  • Treat-to-target
  • Ulcerative colitis

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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