title: Clinical effects of adalimumab treatment with concomitant azathioprine in Japanese Crohn's disease patients.
abstract: OBJECTIVE
  To assess adalimumab's efficacy with concomitant azathioprine (AZA) for induction and maintenance of clinical remission in Japanese Crohn's disease (CD) patients.
  
  
  METHODS
  This retrospective, observational, single-center study enrolled 28 consecutive CD patients treated with adalimumab (ADA). Mean age and mean disease duration were 38.1 ± 11.8 years and 11.8 ± 10.1 years, respectively. The baseline mean Crohn's disease activity index (CDAI) and C-reactive protein were 177.8 ± 82.0 and 0.70 ± 0.83 mg/dL, respectively. Twelve of these patients also received a concomitant stable dose of AZA. ADA was subcutaneously administered: 160 mg at week 0, 80 mg at week 2, followed by 40 mg every other week. Clinical response and remission rates were assessed via CDAI and C-reactive protein for 24 wk.
  
  
  RESULTS
  The mean CDAI at weeks 2, 4, 8, and 24 was 124.4, 120.2, 123.6, and 135.1, respectively. The CDAI was significantly decreased at weeks 2 and 4 with ADA and was significantly suppressed at 24 wk with ADA/AZA. Overall clinical remission rates at weeks 4 and 24 were 66.7% and 63.2%, respectively. Although no statistically significant difference in C-reactive protein was demonstrated, ADA with AZA resulted in a greater statistically significant improvement in CDAI at 24 wk, compared to ADA alone.
  
  
  CONCLUSIONS
  Scheduled ADA with concomitant AZA may be more effective for clinical remission achievement at 24 wk in Japanese Crohn's disease patients.
authors.affiliation: Second Department of Internal Medicine, Osaka Medical College, Takatsuki City, Osaka 569-8686, Japan.
authors.forename: Kumi
authors.initials: K
authors.lastname: Ishida
authors.forename: Takuya
authors.initials: T
authors.lastname: Inoue
authors.forename: Kaori
authors.initials: K
authors.lastname: Fujiwara
authors.forename: Taisuke
authors.initials: T
authors.lastname: Sakanaka
authors.forename: Ken
authors.initials: K
authors.lastname: Narabayashi
authors.forename: Sadaharu
authors.initials: S
authors.lastname: Nouda
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Okada
authors.forename: Kazuki
authors.initials: K
authors.lastname: Kakimoto
authors.forename: Takanori
authors.initials: T
authors.lastname: Kuramoto
authors.forename: Ken
authors.initials: K
authors.lastname: Kawakami
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Abe
authors.forename: Toshihisa
authors.initials: T
authors.lastname: Takeuchi
authors.forename: Mitsuyuki
authors.initials: M
authors.lastname: Murano
authors.forename: Satoshi
authors.initials: S
authors.lastname: Tokioka
authors.forename: Eiji
authors.initials: E
authors.lastname: Umegaki
authors.forename: Kazuhide
authors.initials: K
authors.lastname: Higuchi
mesh_terms: D000068879:Adalimumab; D000328:Adult; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D044466:Asian People; D001379:Azathioprine / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D003424:Crohn Disease / Q000175:diagnosis / Q000188:drug therapy* / Q000208:ethnology; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012074:Remission Induction; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D007166:Immunosuppressive Agents; D000068879:Adalimumab; D001379:Azathioprine
keywords: Adalimumab; Azathioprine; Crohn’s disease; Immunomodulator; Inflammatory bowel disease