P140. Sustained restoration of health related quality of life in Crohn's disease patients with adalimumab maintenance therapy
F. Casellas1, V. Robles2, A. Torrejon2, E. Navarro2, E. Ruiz2, N. Borruel2, 1Hospital Universitari Vall d'Hebron. Ciberehd., Barcelona, Spain, 2Hospital Universitari Vall d'Hebron, Spain
Adalimumab maintenance therapy provided sustained clinical remission and improvement of health related quality of life (HRQOL) for patients with inflammatory or fistulous Crohn's disease (CD). However, there is scarce information about its long-term effect on HRQOL and whether it is able to induce a sustained restoration of patient's perception of health.
Hypothesis: Restoration of normal HRQOL is sustained in patients with long-term clinical remission by treatment with adalimumab.
Objective: To determine HRQOL and restoration of normal perception of health in patients with long-term clinical remission CD induced by adalimumab.
Observational study in patients with CD in clinical remission (CDAI index <150) for at least 12 months, treated with long-term adalimumab 40 mg every other week, with or without thiopurines. Patients were followed each year during 4 years or until clinical relapse (CDAI index >150), intensification or surgery was needed. HRQOL was evaluated with the specific IBDQ-36 items version validated to Spanish. Restoration of health was defined as an overall IBDQ score >209 [JCC 2010;4:637–41]).
From 63 eligible patients, 43 patients with CD in stable clinical remission sustained over one year were included. During the follow-up, at 12 months 43 patients remained in remission, at 24 months 30 patients, at 36 months 15 and in the last visit at 48 months remained 9 patients in clinical remission. Overall score of IBDQ-36 remained unchanged in patients with stable inactive CD, even with a tendency to score better with time (median global score of 226 at 12 months and 241 at 4 years). Restoration of health increased with time (72% to 100% at 1 and 4 years follow-up respectively). Achieve restoration of normal health at 6 months predicts long term good HRQOL.
Sustained clinical remission of CD achieved with maintenance adalimumab treatment restores HRQOL, which remains stable at long-term follow-up.