Abstract
Studies regarding long-term outcomes of adalimumab treatment in non-Caucasian patients with ulcerative colitis (UC) are still lacking. We analyzed long-term outcomes of Korean UC patients on adalimumab treatment in Asan Medical Center, Korea. Between July 2013 and June 2017, adalimumab treatment was commenced on in 72 patients; 49 males (68.1%), median age 40.5 years (Interquartile range [IQR], 24.25–50.00), and median disease duration 39.5 months (IQR, 22.00–85.00) at initiation of adalimumab. Twelve patients (16.7%) had a history of cytomegalovirus colitis within 3 months prior to starting adalimumab. Median duration of adalimumab therapy was 10.50 months (IQR, 2.00–26.75). Seventeen out of 72 patients (23.6%) were primary non-responders, and 7 out of those (9.7%) finally received colectomy. Out of 55 patients who received scheduled adalimumab maintenance therapy, 9 (16.4%) and 3 (5.5%) stopped adalimumab treatment due to loss of response and patients’ preference for discontinuation/loss to follow-up, respectively. Adalimumab dose intensification was required in 22 (40.0%) and corticosteroid rescue therapy was needed in 15 (27.3%) out of 55 patients during adalimumab maintenance therapy. The cumulative proportion of patients without adalimumab discontinuation was 61.0% at 1 year and 56.5% at 3 years among 72 patients who received adalimumab treatment more than once, and 80.1% at 1 year and 74.1% at 3 years among 55 patients who received adalimumab maintenance therapy. History of cytomegalovirus colitis within 3 months prior to starting adalimumab treatment was turned to be a predictor of adalimumab discontinuation (hazard ratio, 3.976; 95% confidence interval, 1.149–13.755; p = 0.029). Long-term outcomes of adalimumab treatment in Korean UC patients appears to be comparable to Western studies. Furthermore, a recent history of cytomegalovirus colitis was a predictor for adalimumab discontinuation.
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