{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T11:29:50Z","timestamp":1771327790505,"version":"3.50.1"},"reference-count":39,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2017,2,6]],"date-time":"2017-02-06T00:00:00Z","timestamp":1486339200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100003130","name":"Fonds Wetenschappelijk Onderzoek","doi-asserted-by":"publisher","award":["G.0617.12"],"award-info":[{"award-number":["G.0617.12"]}],"id":[{"id":"10.13039\/501100003130","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2017,4]]},"abstract":"<jats:title>\n<jats:bold>Summary<\/jats:bold>\n<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Data on dose de\u2010escalation in patients with Crohn's disease (CD) are limited.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To evaluate outcomes of dose de\u2010escalation from adalimumab (ADM) every other week (EOW) to every three weeks (ETW).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We selected patients with CD receiving maintenance therapy with ADM 40 mg ETW with serum levels (SL) available before and after dose de\u2010escalation. Sex\u2010 and age\u2010matched controls continuing ADM 40 mg EOW were identified. Patient reported outcome, C\u2010reactive protein (CRP) and serum albumin were collected.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Out of 898 patients, we identified 40 (11 male, median 37 years) who de\u2010escalated to ADM 40 mg ETW for ADM\u2010related adverse events (AE, <jats:italic>n<\/jats:italic> = 1), ADM SL &gt;7 \u03bcg\/mL (<jats:italic>n<\/jats:italic> = 8), or both (<jats:italic>n<\/jats:italic> = 31). Compared to controls, ADM SL dropped significantly within 4 months, without associated clinical or biochemical changes. In 53% of patients, dose de\u2010escalation was associated with disappearance of AE (8\/16 skin manifestation, 3\/6 arthralgia, 5\/7 frequent infectious episodes). During a median follow\u2010up of 24 months, 65% of patients maintained clinical response, but 35% needed dose escalation back to ADM 40 mg EOW because of clinical relapse (<jats:italic>n<\/jats:italic> = 8), ADM SL &lt;4 \u03bcg\/mL (<jats:italic>n<\/jats:italic> = 2), or both (<jats:italic>n<\/jats:italic> = 4). CRP &lt;3.5 mg\/L at dose de\u2010escalation was independently associated with dose escalation\u2010free survival [odds ratio 6.28 (95% CI 1.83\u201321.59), <jats:italic>P<\/jats:italic> = 0.004]. We could not define a minimal ADM SL to consider or maintain dose de\u2010escalation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Overall, 65% of patients who de\u2010escalated to adalimumab 40 mg every 3 weeks remained in clinical remission for a median of 24 months. In 53% of patients, adalimumab\u2010related adverse events disappeared after dose de\u2010escalation. Regardless of adalimumab SL, disease remission should be assessed objectively prior to dose de\u2010escalation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.13964","type":"journal-article","created":{"date-parts":[[2017,2,6]],"date-time":"2017-02-06T08:06:51Z","timestamp":1486368411000},"page":"923-932","source":"Crossref","is-referenced-by-count":30,"title":["Dose de\u2010escalation to adalimumab 40 mg every 3 weeks in patients with Crohn's disease \u2013 a nested case\u2013control study"],"prefix":"10.1111","volume":"45","author":[{"given":"S.","family":"Van Steenbergen","sequence":"first","affiliation":[{"name":"Department of General Practice KU Leuven Leuven Belgium"},{"name":"Department of Gastroenterology and Hepatology University Hospitals Leuven KU Leuven Leuven Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Bian","sequence":"additional","affiliation":[{"name":"Laboratory for Therapeutic and Diagnostic Antibodies Department of 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