Title :

Adalimumab in Biologic-naïve Patients With Crohn's Disease After Resolution of an Intra-abdominal Abscess: A Prospective Study From the GETAID.

Author(s) :

Bouhnik, Yoram [Auteur]
Hôpital Ambroise Paré [AP-HP]
Pineton De Chambrun, Guillaume [Auteur]
Hôpital Saint Eloi [CHU Montpellier]
Lambert, Jérôme [Auteur]
Hopital Saint-Louis [AP-HP] [AP-HP]
Nachury, Maria [Auteur]
Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286
Seksik, Philippe [Auteur]
CHU Saint-Antoine [AP-HP]
Altwegg, Romain [Auteur]
Hôpital Saint Eloi [CHU Montpellier]
Vuitton, Lucine [Auteur]
Centre Hospitalier Régional Universitaire de Besançon [CHRU Besançon]
Stefanescu, Carmen [Auteur]
Hôpital Ambroise Paré [AP-HP]
Nancey, Stephane [Auteur]
Centre Hospitalier Lyon Sud [CHU - HCL] [CHLS]
Aubourg, Alexandre [Auteur]
CHU Trousseau [Tours]
Serrero, Melanie [Auteur]
Hôpital Nord [CHU - APHM]
Filippi, Jérôme [Auteur]
Centre Hospitalier Universitaire de Nice [CHU Nice]
Desseaux, Kristell [Auteur]
Hopital Saint-Louis [AP-HP] [AP-HP]
Viennot, Stephanie [Auteur]
CHU Caen
Abitbol, Vered [Auteur]
Hôpital Cochin [AP-HP]
Boualit, Madina [Auteur]
Centre hospitalier [Valenciennes, Nord]
Bourreille, Arnaud [Auteur]
Centre Hospitalier Universitaire de Nantes = Nantes University Hospital [CHU Nantes]
Giletta, Cyrielle [Auteur]
Service de Gastroentérologie et pancréatologie [CHU Toulouse]
Buisson, Anthony [Auteur]
CHU Clermont-Ferrand
Roblin, Xavier [Auteur]
Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] [CHU ST-E]
Dib, Nina [Auteur]
Centre Hospitalier Universitaire d'Angers [CHU Angers]
Malamut, Georgia [Auteur]
Hôpital Cochin [AP-HP]
Amiot, Aurélien [Auteur]
Hôpital Henri Mondor
Fumery, Mathurin [Auteur]
CHU Amiens-Picardie
Louis, Edouard [Auteur]
Centre Hospitalier Universitaire de Liège [CHU-Liège]
Elgharabawy, Yasmine [Auteur]
Groupe d’Étude Thérapeutique des Affections Inflammatoires du Tube Digestif [GETAID]
Peyrin-Biroulet, Laurent [Auteur]
Centre Hospitalier Universitaire de Nancy [CHU Nancy]

Journal title :

Clinical Gastroenterology and Hepatology

Abbreviated title :

Clin Gastroenterol Hepatol

Publication date :

2023-02-28

ISSN :

1542-7714

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Background & aims: The management of intra-abdominal abscesses complicating Crohn's disease (CD) is challenging and surgery with delayed intestinal resection is often recommended. The aims of this study were to estimate ...
Show more >Background & aims: The management of intra-abdominal abscesses complicating Crohn's disease (CD) is challenging and surgery with delayed intestinal resection is often recommended. The aims of this study were to estimate the success rate of adalimumab (ADA) in CD patients with an intra-abdominal abscess resolved without surgery, and to identify predictive factors for success.Methods: A multicenter, prospective study was conducted in biologic-naïve CD patients with resolved intra-abdominal abscess treated with ADA with a two-year follow-up. The primary endpoint was ADA failure at W24 defined as a need for steroids after W12, intestinal resection, abscess recurrence, and clinical relapse. Secondary post-hoc endpoint was the long-term success defined as the survival without abscess relapse or intestinal resection at W104. The factors associated with ADA failure at W24 and W104 were identified using a logistic and a cox regression, respectively.Results: From April 2013 to December 2017, 190 patients from 27 GETAID centers were screened, and 117 were included in the analysis. Fifty-eight (50%) patients were male and the median age at baseline was 28 years. At W24, 87 (74%, 95%CI: 65.5-82.0, n=117) patients achieved ADA success. Among the 30 patients with ADA failure, 15 underwent surgery. At W104, the survival rate without abscess recurrence or surgery was 72·9% (95%CI: 62.1-79.8, n=109). Abscess drainage was significantly associated with ADA failure at W24 (OR=4.18; 95%CI: 1.06-16.5; p=0.043). Disease duration (HR=1.32, 95%CI: 1.09-1.59, p=0.008), abscess drainage (HR=5.59, 95%CI: 2.21-14.15, p=0.001), and inflammatory changes in mesenteric fat (HR=0.4, 95%CI: 0.17-0.94, p=0.046) were significantly associated with ADA failure at W104.Conclusion: Provided that the abscess was carefully managed before initiating medical treatment, this study showed the high efficacy of ADA in the short and long term in biologic-naïve patients with CD complicated by an intra-abdominal abscess.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

Université de Lille
Inserm
CHU Lille

Collections :

• Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286

Submission date :

2024-01-11T23:25:13Z
2024-03-19T13:34:58Z