Effects of adalimumab therapy on incidence of hospitalization and surgery in Crohn's disease: results from the CHARM study.

Authors:
Brian G Feagan, Remo Panaccione, William J Sandborn, Geert R D'Haens, Stefan Schreiber, Paul J Rutgeerts, Edward V Loftus, Kathleen G Lomax, Andrew P Yu, Eric Q Wu, Jingdong Chao, Parvez Mulani
Year of publication:
2008
Volume:
135
Issue:
5
Issn:
0016-5085
Journal title abbreviated:
GASTROENTEROLOGY
Journal title long:
Gastroenterology (New York, N.Y. 1943)
Impact factor:
18.187
Abstract:
We determined the effects of adalimumab maintenance treatment on the risks of hospitalization and surgery in Crohn''s disease (CD).A total of 778 patients with CD were randomized to placebo, adalimumab 40 mg every other week or adalimumab 40 mg weekly, all after an 80-mg/40-mg adalimumab induction regimen. All-cause and CD-related hospitalizations and major CD-related surgeries were compared between the placebo and adalimumab groups (every other week, weekly, and both combined) using Kaplan-Meier analysis and Cox proportional hazard models.Both 3- and 12-month hospitalization risks were significantly lower for patients who received adalimumab. Hazard ratios for all-cause hospitalization were 0.45, 0.36, and 0.40 for the adalimumab every other week, weekly, and combined groups, respectively (all P < .01 vs placebo). Hazard ratios for CD-related hospitalization were 0.50, 0.34, and 0.42, respectively (all P < .05). Cox model estimates demonstrated adalimumab every other week and weekly maintenance therapies were associated with 52% and 60% relative reductions in 12-month, all-cause hospitalization risk, and 48% and 64% reductions in 12-month risk of CD-related hospitalization. The combined adalimumab group was associated with 56% reductions in both all-cause and CD-related hospitalization risks. Fewer CD-related surgeries occurred in the adalimumab every other week, weekly, and combined groups compared with placebo (0.4, 0.8, and 0.6 vs 3.8 per 100 patients; all P < .05).Patients with moderate-to-severe CD treated with adalimumab had lower 1-year risks of hospitalization and surgery than placebo patients.