title: Survey on the use of adalimumab as maintenance therapy in Crohn's disease in England and Ireland.
abstract: BACKGROUND
  Adalimumab is effective in inducing and maintaining response/remission in patients with Crohn's disease either naive to biological therapies or after secondary failure of infliximab.
  
  
  OBJECTIVE
  To present the first 'real-life' survey data from England and Ireland on the use of adalimumab.
  
  
  METHODS
  A retrospective audit conducted through a web-based questionnaire in England/Ireland.
  
  
  RESULTS
  We analysed data on 61 patients (35 female, 26 male) with a median age of 33 years (range 17-71 years) and an average follow-up of 8 months. The maximal maintenance dose was 40 mg every other week in 84% of patients, 40 mg weekly in 13% and 80 mg weekly in 3%. Maintenance adalimumab achieved remission in 57% of patients. The ongoing response rate was 83.6%. An additional 8% had a secondary loss of response after an average of 8.4 months (range 2-17). Adverse effects were observed in 23% of patients: of which there was local pain in 29%, infection in 36%, headaches in 14%, leucopenia (on azathioprine) in 7%, a painful rash in 7% and serum-sickness-type reaction in 7%. Adverse events led to discontinuation in two patients.
  
  
  CONCLUSIONS
  This English/Irish audit shows an acceptable response/remission and safety profile of adalimumab in the treatment of Crohn's disease. In contrast to earlier data from Scotland, dose escalation was only observed in 16% of patients. The majority of responders were steroid-free at follow-up.
authors.affiliation: Hammersmith Hospital, London, UK.
authors.forename: Evangelos A
authors.initials: EA
authors.lastname: Russo
authors.forename: Marietta
authors.initials: M
authors.lastname: Iacucci
authors.forename: James O
authors.initials: JO
authors.lastname: Lindsay
authors.forename: Simon
authors.initials: S
authors.lastname: Campbell
authors.forename: Ailsa
authors.initials: A
authors.lastname: Hart
authors.forename: John
authors.initials: J
authors.lastname: Hamlin
authors.forename: Timothy
authors.initials: T
authors.lastname: Orchard
authors.forename: Naila
authors.initials: N
authors.lastname: Arebi
authors.forename: Jeremy
authors.initials: J
authors.lastname: Nightingale
authors.forename: Meron R
authors.initials: MR
authors.lastname: Jacyna
authors.forename: Simon M
authors.initials: SM
authors.lastname: Gabe
authors.forename: Marian
authors.initials: M
authors.lastname: O'Connor
authors.forename: Adrian W
authors.initials: AW
authors.lastname: Harris
authors.forename: Colm
authors.initials: C
authors.lastname: O'Morain
authors.forename: Subrata
authors.initials: S
authors.lastname: Ghosh
mesh_terms: D000068879:Adalimumab; D000293:Adolescent; D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D003424:Crohn Disease / Q000188:drug therapy* / Q000453:epidemiology; D017723:Drug Utilization Review; D004739:England / Q000453:epidemiology; D005260:Female; D005765:Gastrointestinal Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D019538:Health Care Surveys; D006801:Humans; D020407:Internet; D007494:Ireland / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D012074:Remission Induction; D012189:Retrospective Studies; D013256:Steroids / Q000627:therapeutic use; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D005765:Gastrointestinal Agents; D013256:Steroids; D000068879:Adalimumab