Clinical Outcomes and Predictors of Response for Adalimumab in Patients with Moderately to Severely Active Ulcerative Colitis: A KASID Prospective Multicenter Cohort Study

Abstract A prospective, observational, multicenter study was conducted over 56 weeks in 146 adult patients with moderately to severely active ulcerative colitis (UC) who received adalimumab (ADA) at 17 Korean academic hospitals. Clinical response rates were 52.1% and 37.7% and clinical remission rates were 24.0% and 21.9% at weeks 8 and 56, respectively. Mucosal healing rates were 39.0% and 30.1% at weeks 8 and 56, respectively. Prior use of anti-tumor necrosis factor-α (anti-TNF-α) did not affect clinical outcomes. The ADA drug level was significantly higher in patients with better outcomes at week 8. In patients with lower endoscopic activity, higher body mass index, and higher serum albumin levels at baseline, the clinical response rate was higher at week 8. In patients with lower Mayo scores and C-reactive protein levels, clinical responses, and mucosal healing at week 8, the clinical response rate was higher at week 56. Serious adverse drug reactions were identified in 2.7% of patients. ADA is effective and safe for induction and maintenance in Korean patients with UC, regardless of prior anti-TNF-α therapy. The ADA drug level is associated with the efficacy of induction therapy. Patients with better short-term outcomes were predictive of those with an improved long-term response