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001-es BibID:	BIBFORM028490
Első szerző:	Kiss Lajos Sándor
Cím:	Early clinical remission and normalisation of CRP are the strongest predictors of efficacy, mucosal healing and dose escalation during the first year of adalimumab therapy in Crohn's disease / Kiss, L. S., Szamosi, T., Molnar, T., Miheller, P., Lakatos, L., Vincze, A., Palatka, K., Barta, Z., Gasztonyi, B., Salamon, A., Horvath, G., Tóth, G. T., Farkas, K., Banai, J., Tulassay, Z., Nagy, F., Szenes, M., Veres, G., Lovasz, B. D., Vegh, Z., Golovics, P. A., Szathmari, M., Papp, M., Lakatos, P. L.
Dátum:	2011
ISSN:	0269-2813
Megjegyzések:	Adalimumab is a fully human monoclonal antibody targeting tumour necrosis factor with proven efficacy in the treatment of Crohn's disease (CD). AIM: To investigate the predictors of medium-term clinical efficacy and mucosal healing during adalimumab therapy, in patients with CD, in specialised centres approved for biological therapy in Hungary. METHODS: Data capture of the 201 CD patients was standardised and prospective (male/female: 112/89, median age: 33.0 years, duration: 8 years). Previous infliximab therapy had been administered in 48% of patients, concomitant steroids in 41%, azathioprine in 69% and combined therapy in 27% of patients. RESULTS: Overall clinical response and remission rates at 24 weeks were 78% and 52%, respectively; at 52 weeks were 69% and 44%, respectively. Endoscopic improvement and healing were achieved in 43% and 24% of patients. In a logistic regression model, clinical efficacy and CRP at week 12, need for combined immunosuppression at induction, shorter disease duration and smoking were identified as independent predictors for 12-month clinical outcome, whereas CRP at week 12, clinical remission at week 24, inflammatory parameters and nonsmoking were associated to endoscopic improvement/healing. Intensification to weekly dosing was needed in 16% of patients. Parallel azathioprine therapy and clinical remission at week 12 were inversely associated with dose escalation. CONCLUSIONS: Clinical efficacy and normalised CRP at week 12 (early deep clinical remission) are associated with medium-term clinical efficacy and mucosal healing during adalimumab therapy, whereas need for combined immunosuppression at induction and smoking status are predictors for non-response. Parallel azathioprine therapy may decrease the probability for dose escalation.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban egyetemen (Magyarországon) készült közlemény
Megjelenés:	Alimentary Pharmacology & Therapeutics. - 34 : 8 (2011), p. 911-922. -
További szerzők:	Szamosi Tamás Molnár Tamás (orvos Szeged) Miheller Pál Lakatos László (Veszprém) Vincze A. (orvos Pécs) Palatka Károly (1961-) (belgyógyász, gasztroenterológus) Barta Zsolt (1964-) (belgyógyász, gasztroenterológus) Gasztonyi Beáta Salamon A. (orvos Zalaegerszeg) Horváth Gábor (orvos Miskolc) Tóth Gábor Tamás Farkas Katalin Banai János Tulassay Zsolt (1944-) (belgyógyász, gasztroenterológus) Nagy Ferenc (orvos Szeged) Szenes Mária Veres Gábor (1969-2020) (csecsemő- és gyermekgyógyász, gasztroenterológus) Lovász Barbara Dorottya Végh Zsuzsanna Golovics Petra Anna Szathmári Miklós Papp Mária (1975-) (belgyógyász, gasztroenterológus) Lakatos Péter (Semmelweis Egyetem)
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001-es BibID:	BIBFORM040343
Első szerző:	Molnár T. (orvos)
Cím:	Predictors of relapse in patients with Crohn's disease in remission after 1 year of biological therapy / Molnár T., Lakatos P. L., Farkas K., Nagy F., Szepes Z., Miheller P., Horváth G., Papp M., Palatka K., Nyári T., Bálint A., Lőrinczy K., Wittmann T.
Dátum:	2013
Megjegyzések:	BACKGROUND: Some of the most important questions relating to the use of biological therapy in inflammatory bowel diseases concern the duration of maintenance therapy. AIM: To assess the disease course and frequency of relapse of Crohn's disease (CD) following discontinuation of biological therapy, and to determine predictive factors for relapse. METHODS: One hundred twenty-one CD patients who had achieved clinical remission following 1 year of biological therapy and for whom biological therapy was then discontinued participated in this prospective observational study. Eighty-seven CD patients had received infliximab and 34 adalimumab. The definition of relapse was an increase of >100 points in CDAI to at least a CDAI of 150 points. RESULTS: Biological therapy was restarted within 1 year of treatment cessation in 45% of patients. Logistic regression analysis revealed that previous biological therapy (P = 0.011) and dose intensification during the 1-year course of biological therapy (P = 0.024) were associated with the need for and the time to the restarting of biological therapy. Smoking was observed to have an effect that was not statistically significant (P = 0.053). CONCLUSIONS: Biological therapy was restarted a median of 6 months after discontinuation in almost half of Crohn's disease patients in who had been in clinical remission following 1 year of biological therapy. These results suggest that, in the event of the presence of certain predictive factors, biological therapy should probably be continued for more than 1 year by most patients.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:	Alimentary Pharmacology and Therapeutics. - 37 : 2 (2013), p. 225-233. -
További szerzők:	Lakatos Péter (Semmelweis Egyetem) Farkas K. Nagy Ferenc (orvos Szeged) Szepes Zoltán Miheller Pál Horváth G. Papp Mária (1975-) (belgyógyász, gasztroenterológus) Palatka Károly (1961-) (belgyógyász, gasztroenterológus) Nyári Tibor Bálint Anita Lőrinczy K. Wittmann Tibor
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