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Original Research ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Med. | doi: 10.3389/fmed.2019.00234

Administration Timing is the Best Clinical Outcome Predictor for Adalimumab Administration in Crohn’s disease

 Marcello Chieppa1*, Mauro Mastronardi2, Margherita Curlo2, Osvaldo Burattini2, Renato Cuppone2,  Cavalcanti Elisabetta2, Stefania De Santis3,  Grazia Serino2,  Pasqua L. Pesole2, Elisa Stasi2,  Maria Lucia Caruso2 and Pietro Giorgio2
  • 1Immunopathology, National Institute of Gastroenterology S. de Bellis Research Hospital (IRCCS), Italy
  • 2National Institute of Gastroenterology S. de Bellis Research Hospital (IRCCS), Italy
  • 3Department of Pharmacy, University of Salerno, Italy

Biological intervention for Crohn’s Disease (CDs) patients, mainly using anti-TNF antibodies, is often an efficient therapeutic solution. Nonetheless, data defining the administration timing to maximize the chances of clinical remission are lacking. The objective of this “real-life” retrospective study was to evaluate if early Adalimumab (ADA) administration (<12 months) was an efficient strategy to improve patients' clinical outcome. This single center study included 157 CD patients, of which 80 received the first ADA administration within the first 12 months from the diagnosis. After one year of therapy, clinical remission was observed in 50,32% of patients, mucosal healing in 37.58%. Clinical remission was observed in 66,25% of the early ADA administration patients vs 33,77% of the late (>12 months) (p <0.001) ; mucosal healing was observed in 53,75% of the early vs 20,78% of the late (p<0,001). Dose escalation was required for 30,00% of the early vs 66,23% of the late (<0,01). In the early ADA administration group, 7.50% patients was considered non-responder at the end of the follow-up versus 22,08% patients in the late administration group. These finding highlighted that early ADA administration (within 1 year of diagnosis) improves the clinical response and mucosal healing and reduces the loss of response rate and need for dose escalation.

Keywords: Crohn’s disease, Anti-TNF-α agents, Adalimumab (ADA), timing, Clinical remission rate

Received: 27 May 2019; Accepted: 03 Oct 2019.

Copyright: © 2019 Chieppa, Mastronardi, Curlo, Burattini, Cuppone, Elisabetta, De Santis, Serino, Pesole, Stasi, Caruso and Giorgio. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Dr. Marcello Chieppa, National Institute of Gastroenterology S. de Bellis Research Hospital (IRCCS), Immunopathology, Bari, 70013, Italy, transmed@irccsdebellis.it