Adalimumab versus azathioprine to halt the progression of bowel damage in Crohn’s disease: application of Lémann Index

Davide Giuseppe Ribaldone, Gian Paolo Caviglia, Rinaldo Pellicano, Marta Vernero, Andrea Italia, Mario Morino, Giorgio Maria Saracco, Marco Astegiano

Research output: Contribution to journalArticle

Abstract

Background: The Lémann Index (LI) was recently developed to evaluate the cumulative bowel damage in patients with Crohn’s disease (CD). Aims: To search for a difference between adalimumab and azathioprine to halt the progression of bowel damage in active CD, using the LI. Methods: A single-centre, retrospective study was conducted. Patients with CD were included if they had colonoscopy and magnetic resonance enterography performed within 4 months from the start of adalimumab or azathioprine and repeated after 12 months of therapy. Primary outcome was reached if the increase of LI after 12 months of treatment was <0.3, the drug was not stopped, and the use of systemic steroids was continued for no more than 3 months. Results: Ninety-one patients were enrolled, 31 (34.1%) of them treated with adalimumab and 60 (65.9%) with azathioprine. Sixty-seven percent of patients treated with adalimumab reached the primary outcome compared to 28.3% of patients treated with azathioprine (p =.0006). The LI in the group on adalimumab therapy decreased after 12 months (from 9.9 to 8.8), while in the group on azathioprine therapy it increased (from 7.7 to 8.8). Conclusion: Treatment with adalimumab halts the progression of bowel damage in CD while that with azathioprine does not.

Original languageEnglish
JournalScandinavian Journal of Gastroenterology
DOIs
Publication statusAccepted/In press - Jan 1 2019
Externally publishedYes

Fingerprint

Azathioprine
Crohn Disease
Therapeutics
Colonoscopy
Adalimumab
Magnetic Resonance Spectroscopy
Retrospective Studies
Steroids
Pharmaceutical Preparations

Keywords

  • Anti-TNF
  • colonoscopy
  • magnetic resonance enterography
  • small intestine
  • thiopurine

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Adalimumab versus azathioprine to halt the progression of bowel damage in Crohn’s disease : application of Lémann Index. / Ribaldone, Davide Giuseppe; Caviglia, Gian Paolo; Pellicano, Rinaldo; Vernero, Marta; Italia, Andrea; Morino, Mario; Saracco, Giorgio Maria; Astegiano, Marco.

In: Scandinavian Journal of Gastroenterology, 01.01.2019.

Research output: Contribution to journalArticle

Ribaldone, Davide Giuseppe ; Caviglia, Gian Paolo ; Pellicano, Rinaldo ; Vernero, Marta ; Italia, Andrea ; Morino, Mario ; Saracco, Giorgio Maria ; Astegiano, Marco. / Adalimumab versus azathioprine to halt the progression of bowel damage in Crohn’s disease : application of Lémann Index. In: Scandinavian Journal of Gastroenterology. 2019.
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