title: Early intervention with adalimumab may contribute to favorable clinical efficacy in patients with Crohn's disease.
abstract: BACKGROUND
  We evaluated the clinical efficacy of adalimumab (ADA) for Crohn's disease (CD) and analyzed predictive factors for clinical remission and long-term prognosis.
  
  
  METHODS
  We retrospectively reviewed the medical records of 45 patients treated with ADA for CD at Keio University Hospital between October 2010 and March 2014. Clinical remission was defined as a Harvey-Bradshaw index of ≤4.
  
  
  RESULTS
  Twenty-eight of 45 patients (62.2%) achieved clinical remission at week 4. Among these 28 patients, 18 patients (64.3%) maintained clinical remission at week 26, and among these, 16 patients (88.9%) maintained clinical remission at week 52. Absence of a history of bowel resection and absence of prior anti-tumor necrosis factor (anti-TNF) therapy were significant predictive factors for clinical remission at week 4 upon multivariate logistic regression analyses. Younger age and a disease duration of ≤3 years correlated with clinical remission at week 26 upon univariate analyses. Patients without a history of bowel resection showed significantly better long-term prognosis than those with a history of bowel resection (p = 0.01). None of the patients contracted a serious infectious disease.
  
  
  CONCLUSIONS
  Younger age, shorter duration of disease, being naive to anti-TNF antagonists, and absence of a history of bowel resection were associated with the efficacy of ADA in CD patients.
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Miyoshi
authors.forename: Tadakazu
authors.initials: T
authors.lastname: Hisamatsu
authors.forename: Katsuyoshi
authors.initials: K
authors.lastname: Matsuoka
authors.forename: Makoto
authors.initials: M
authors.lastname: Naganuma
authors.forename: Yuriko
authors.initials: Y
authors.lastname: Maruyama
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Yoneno
authors.forename: Kiyoto
authors.initials: K
authors.lastname: Mori
authors.forename: Hiroki
authors.initials: H
authors.lastname: Kiyohara
authors.forename: Kosaku
authors.initials: K
authors.lastname: Nanki
authors.forename: Susumu
authors.initials: S
authors.lastname: Okamoto
authors.forename: Tomoharu
authors.initials: T
authors.lastname: Yajima
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Iwao
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Ogata
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Hibi
authors.forename: Takanori
authors.initials: T
authors.lastname: Kanai
mesh_terms: D000068879:Adalimumab; D000293:Adolescent; D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D003424:Crohn Disease / Q000188:drug therapy*; D061345:Early Medical Intervention; D005260:Female; D006801:Humans; D007422:Intestines / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012074:Remission Induction; D012189:Retrospective Studies; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors; D055815:Young Adult
chemical_list: D000893:Anti-Inflammatory Agents; D061067:Antibodies, Monoclonal, Humanized; D014409:Tumor Necrosis Factor-alpha; D000068879:Adalimumab