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P569. Adalimumab was more effective in the patients with bio-naive and early Crohn's disease

T. Hisamatsu1, K. Matsuoka1, M. Naganuma2, J. Miyoshi1,3, N. Inoue4, T. Yajima1, S. Mizuno1, K. Saigusa1, Y. Nakazato1, K. Mori1, K. Takeshita1, K. Nanki1, H. Kiyohara1, Y. Iwao4, H. Ogata2, T. Kanai1, 1Keio University, School of Medicine, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Tokyo, Japan, 2Keio University, Center for Diagnostic and Therapeutic Endoscopy, Tokyo, Japan, 3Tokyo Dental University, Ichikawa General Hospital, Department of Internal Medicine, Ichikawa, Japan, 4Keio University, Center for Preventive Medicine, Tokyo, Japan

Background

Crohn's disease has been considered as a progressive disease which causes disability. It has been expected that anti-TNF mAbs therapy can change natural history of Crohn's disease. Therefore, to find the characteristics of patients in whom anti-TNF mAbs show maximum efficacy is important. Recently, subgroup analysis of CHARM trial showed clinical remission rates through 3 years of treatment are highest in the shortest disease duration subgroup (Schreiber S, et al. J Crohns Colitis. 2013 Apr 1; 7(3): 213–21). In this study, we analyzed factors that correlates with clinical remission rates in Crohn's disease patients treated with adalimumab (ADA).

Methods

Forty-five patients with Crohn's disease in whom ADA was started at Keio University Hospital from Oct 1 in 2010 to Apr 30 in 2013 were analyzed retrospectively.

Clinical assessment was done by Harvey–Bradshaw Index (HBI). Clinical Remission was defined as HBI ≤4. Factors that correlates with clinical remission rates at week 4 and week 26 was analyzed by univariate analyses and multivariate logistic regression analyses.

Results

Univariate analyses showed that younger age (p < 0.05), disease duration (≤3 years) (p = 0.02), no previous history of bowel resection (<0.001), and bio-naïve (<0.01) correlate with clinical remission rates at week 4. Multivariate logistic regression analyses showed that no previous history of bowel resection (p = 0.026) and bio-naïve (p = 0.042) correlate with clinical remission rates at week 4.

Univariate analyses showed that remission at week 4 (p < 0.0001), younger age (p < 0.005), disease duration (≤3 years) (p < 0.001), and bio-naïve (p = 0.0040) correlate with clinical remission rates at week 26.

Conclusion

Our retrospective, single center observation study showed that ADA is more effective in the patients with bio-naive and early Crohn's disease.