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Clinical effects of adalimumab treatment with concomitant azathioprine in Japanese Crohn’s disease patients
作者姓名:Kumi Ishida  Takuya Inoue  Kaori Fujiwara  Taisuke Sakanaka  Ken Narabayashi  Sadaharu Nouda  Toshihiko Okada  Kazuki Kakimoto  Takanori Kuramoto  Ken Kawakami  Yosuke Abe  Toshihisa Takeuchi  Mitsuyuki Murano  Satoshi Tokioka  Eiji Umegaki  Kazuhide Higuchi
作者单位:the Second Department of Internal Medicine, Osaka Medical College, Takatsuki City
摘    要:AIM: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, singlecenter 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. CONCLUSION:Scheduled ADA with concomitant AZA may be more effective for clinical remission achievement at 24 wk in Japanese Crohn’s disease patients.

关 键 词:Crohn’s  disease  Adalimumab  Immunomodulator  Azathioprine  Inflammatory  bowel  disease
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