Efficacy And Safety Analysis Of Adalimumab In 93 Patients With Crohn’s Disease

Objectives:To evaluate the efficacy and safety of adalimumab in Crohn’s disease.Methods:Retrospective analysis of 93 patients with Crohn’s disease who received Adalimumab at the Second Xiangya Hospital of Central South University,the treatment responses of the clinical remission（CDAI<150）at 3 months and the endoscopic remission（CDEIS<3）within 1 year were evaluated;patients with small bowel Crohn’s disease were evaluated by radiological response within 1year.Adverse events were monitored in the whole treatment.The factors influencing the endoscopy remission were analyzed by multivariate logistic Regression analysis.Results:（1）A retrospective analysis was performed on 93 patients with Crohn’s disease who were treat with Adalimumab in The Second Xiangya Hospital of Central South University,clinical remission（CDAI<150）rates at 3 months and1 year in patients with the treatment of Adalimumab were 76.3%（71/93）,73.8%（65/88）respectively,and it were 58.1%（25/43）,64.1%（25/39）in patients with moderate to severe Crohn’s disease（CDAI>220）respectively.（2）Within 1 year,the endoscopic remission（CDEIS<3）was 31.3% （21/67）,the radiological remission rate was 22.2%（2/9）in patients with small bowel Crohn’s disease.（3）There was no statistical difference in endoscopic remission rates in patients with Adalimumab as the first-line treatment or as later-line treatment（χ2=0.699,P=0.403）.（4）Multivariate regression analysis showed that the factors of CDEIS in baseline<5 and clinical remission at 3 months contribute to achieving endoscopic remission（p₁=0.001,OR₁=0.008,OR₁95%CI 0.01-0.123;P₂=0.016,OR₂=50.22,OR₂95%CI 2.054-1227.725）;Compared to the ileocolonic Crohn’s disease,small intestine Crohn’s disease was an impediment factor for endoscopic remission（P=0.030,OR=61.999,OR 95%CI 1.491-2578.761）.（5）The adverse events rate was 40.9%（38/93）,most of them were tolerable.Conclusions:Retrospective studies based on our center have shown that adalimumab is well-tolerated and effective rescue therapy for patients with Crohn’s disease.The factors of CDEIS in baseline<5 and clinical remission at 3 months contribute to achieving endoscopic remission,CDEIS<5 points at baseline and clinical remission achieved within 3 months were contributing factors to endoscopic remission,small intestine Crohn’s disease was an impediment factor for endoscopic remission.