Short and long-term efficacy of adalimumab in ulcerative colitis: a real-life study

Leif Angelison, Sven Almer, Loa Davidsdottir, Per Hammarlund, Stefan Lindgren, Ulf Hindorf, Jan Marsal, Erik Hertervig

Research output: Contribution to journalArticlepeer-review


Objective: Randomized controlled trials have shown the effectiveness of Adalimumab in ulcerative colitis. However, real-life data is scarce. We aimed to assess the effectiveness and predictive factors of effectiveness in a large Swedish cohort. Methods: Retrospective capture of data from local registries at five Swedish IBD centers. Clinical response and remission rates were assessed at three months after starting adalimumab treatment and patients were followed until colectomy or need for another biological. Bio-naive patients were compared to bio experienced patients. Factors associated with short term responses were assessed using logistic regression model. Failure on drug was assessed using a Cox proportional hazards regression model. Results: 118 patients (59 males, 59 females) with median age 34.4 years (IQR 27.0–51.4) were included. Median disease duration was 4.3 years (IQR 2.0–9.0) and follow-up 1.27 years (IQR 0.33–4.1). A clinical corticosteroid-free remission was achieved by 38/118 (32.2%) and response by 91/118 (77%) after three months. CRP >3 mg/l at baseline was predictive of short-term failure to reach corticosteroid-free remission. Factors associated with survival on the drug were male gender, CRP <3 mg/l and absence of primary sclerosing cholangitis. Patients >42 years of age at diagnosis were more likely to respond to adalimumab and remain on treatment compared to patients <20 years. Conclusions: An elevated CRP-level, primary sclerosing cholangitis and female gender were predictors of treatment failure. In contrast older age at diagnosis was a predictor of short-term clinical response and drug survival. Prior infliximab failure, regardless of cause, did not influence the outcome of adalimumab treatment.

Original languageEnglish
Pages (from-to)154-162
Number of pages9
JournalScandinavian Journal of Gastroenterology
Issue number2
Early online date2020 Jan 21
Publication statusPublished - 2020

Subject classification (UKÄ)

  • Gastroenterology and Hepatology

Free keywords

  • Adalimumab
  • predictors of response
  • real life study
  • ulcerative colitis


Dive into the research topics of 'Short and long-term efficacy of adalimumab in ulcerative colitis: a real-life study'. Together they form a unique fingerprint.

Cite this