title: Adalimumab real-world dosage pattern and predictors of weekly dosing: patients with Crohn's disease in the United States.
abstract: OBJECTIVE
  To determine the real-world dosage pattern of adalimumab and predictors for weekly dosing in Crohn's disease (CD).
  
  
  METHODS
  Patients with CD receiving adalimumab maintenance therapy (≥3 dispensing events within 1 year) were identified from a large specialty pharmacy database in the United States (March 2007-July 2008). Weekly dosing rates (≥2 consecutive weekly doses after the first dispensing event) for a 12-month period were estimated with Kaplan-Meier methods. Predictors for weekly dosing were identified using Cox proportional-hazards regression.
  
  
  RESULTS
  The overall adalimumab weekly dosing rate was 11.3% (151 of 1335 patients). The 12-month cumulative risk of weekly dosing was 15.5%. Patients who received a 160-/80-mg induction regimen had half the risk for weekly dosing compared with other induction regimens (hazard ratio, 0.48; 95% confidence intervals 0.33-0.7; p<0.0001). Weekly dosing rates were significantly lower in the West and South vs. the Northeast.
  
  
  CONCLUSIONS
  The adalimumab weekly dosing rate in a real-world, managed-care setting is less than that in clinical trials and academic centres. Geographic region and not starting on 160-/80-mg induction therapy were significantly associated with weekly adalimumab use for patients with CD.
authors: Division of Gastroenterology & Hepatology, Mayo Clinic, Rochester, MN, USA. loftus.edward@mayo.edu
authors: Edward V
authors: EV
authors: Loftus
authors: Xiaoyun
authors: X
authors: Pan
authors: Pete
authors: P
authors: Zurawski
authors: Parvez
authors: P
authors: Mulani
authors: Jingdong
authors: J
authors: Chao
mesh_terms: D000068879:Adalimumab; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage* / Q000627:therapeutic use; D003424:Crohn Disease / Q000188:drug therapy*; D016208:Databases, Factual; D006801:Humans; D053208:Kaplan-Meier Estimate; D060046:Maintenance Chemotherapy / Q000706:statistics & numerical data; D008875:Middle Aged; D016016:Proportional Hazards Models; D012074:Remission Induction; D013997:Time Factors; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors; D014481:United States
chemical_list: D000893:Anti-Inflammatory Agents; D061067:Antibodies, Monoclonal, Humanized; D014409:Tumor Necrosis Factor-alpha; D000068879:Adalimumab