Normalización a largo plazo de la calidad de vida de los pacientes con enfermedad de Crohn con terapia de mantenimiento con adalimumab

F. Casellas, C. Herrera de Guise, V. Robles, A. Torrejón, E. Navarro, N. Borruel
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Abstract

Background

Maintenance treatment of Crohn's disease (CD) with adalimumab achieves sustained clinical remission and improves health-related quality of life (HRQOL) of patients. There is, however, no information about its long-term effect on normalization of patient's perceived health.

Objectives

To determine the long-term normal perception of health in CD patients in clinical remission with adalimumab.

Methods

Retrospective, observational study in CD patients in clinical remission for 36 months follow-up, treated with adalimumab 40 mg eow. Patients requiring a change of treatment or surgery were not included. HRQOL was assessed with the specific questionnaire IBDQ-36. The normalization of health was defined as an overall score ≥ 209.

Results

Twenty eight patients were included in sustained clinical remission for 36 months. Three patients required further escalation and de-escalation of the dose. The IBDQ-36 overall score remained unchanged in patients with inactive stable CD and even tended to increase with time (median overall score of 230 at 6 months and 238 at 3 years). The rate of normalization of health increased with time (68% to 78% at 6 and 36 months respectively).

Conclusions

Sustained clinical remission with effective maintenance treatment with adalimumab restores the perception of normal health of most of the patients with CD.

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阿达木单抗维持治疗克罗恩病患者生活质量的长期正常化
背景:使用阿达木单抗对克罗恩病(CD)进行维持治疗可实现持续的临床缓解并改善患者的健康相关生活质量(HRQOL)。然而,没有关于其对患者感知健康正常化的长期影响的信息。目的了解阿达木单抗临床缓解期乳糜泻患者的长期正常健康感觉。方法回顾性观察研究对临床缓解的CD患者进行36个月的随访,阿达木单抗40mg / d治疗。需要改变治疗或手术的患者不包括在内。HRQOL采用IBDQ-36问卷进行评估。健康归一化定义为总分≥209分。结果28例患者临床持续缓解36个月。3名患者需要进一步增加或减少剂量。非活动型稳定期CD患者的IBDQ-36总分保持不变,甚至有随时间增加的趋势(6个月时中位总分为230,3年时中位总分为238)。健康正常化率随时间增加(6个月至36个月分别为68%至78%)。结论阿达木单抗有效的维持治疗可使大多数CD患者恢复对正常健康状况的感知。
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