P0870 Efficacy and Safety of Different Doses of Adalimumab in Crohn's Disease: A Multicenter Cohort Study in Infliximab-Naïve and Infliximab-Exposed Patients
Z Xu, X Peng, M Zhi, M ZhangAbstract
Background
High adalimumab dosing for Crohn's disease remains uncertain. This study evaluated the efficacy and safety of different adalimumab doses in infliximab-naïve and -exposed patients to guide individualized therapy.
Methods
A retrospective, multicenter cohort study with propensity score weighting included Crohn’s disease patients treated at Sun Yat-sen University Sixth Affiliated Hospital from January 2019 to July 2022. Clinical remission, objective response, and sustained remission rates were assessed at 12 and 52 weeks.
Results
Of 223 patients (165 standard-dose, 58 high-dose), propensity score–adjusted analysis showed no difference in clinical remission at Week 12 between high- and standard-dose groups (80.2% vs. 79.8%, P = 0.952). Infliximab exposure affected outcomes, with higher remission in the high-dose group among previously exposed patients (74.6% vs. 39.1%, P = 0.013). By Week 52, clinical remission was similar (65.2% vs. 50.8%, P = 0.099), though objective response was superior in the high-dose group for infliximab-exposed patients (71.9% vs. 25.2%, P = 0.002). In TNF-naïve patients, high-dose adalimumab increased Week 12 response (94.3% vs. 78.7%, P = 0.039) and Week 52 objective remission (48.1% vs. 30.0%, P = 0.037). Safety profiles were comparable, with similar adverse event rates (58.6% vs. 56.4%, P = 0.878).
Conclusion
High-dose adalimumab offers therapeutic benefits for infliximab-exposed patients in short- and long-term phases, an effect not observed in infliximab-naïve patients, with comparable safety to standard dosing.