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Gastroenterol Hepatol. 2011 Aug-Sep;34(7):443-8. doi: 10.1016/j.gastrohep.2011.04.001. Epub 2011 Jul 2.

Adalimumab is effective in long-term real life clinical practice in both luminal and perianal Crohn's disease. The Madrid experience.

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Digestive Disease Department, Hospital Gregorio Marañón, Madrid, Spain.



To evaluate effectiveness and safety of adalimumab in CD patients of the Madrid area and identify predictors of response.


Multicenter retrospective survey of all CD patients treated with adalimumab in 9 hospitals of the Madrid area (Spain). Univariate and multivariate analysis of predictors of response was performed.


174 patients included (50% males) with a median follow-up of 40 weeks. 30% had active perianal fistulizing disease at the beginning of the therapy with adalimumab. 59% had been previously treated with infliximab, being the lost of response (42.2%) the most frequent cause of withdrawal of the drug. 33% of patients needed dose escalation from every-other week to every week. The median time for this dose escalation was 33 weeks (range 2-120). The percentages of complete response at 4 weeks, 6 months and end of follow-up were 63, 70 and 63% in luminal disease and 49, 50 and 41% in perianal disease respectively. The prevalence of adverse events was 18% (most frequent was: 5 abscesses) causing the withdrawal of the drug in 21% of them.


Adalimumab is effective and safe for the management of CD, even in refractory cases to infliximab.

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