The objective of this study was to review loss of response and need for adalimumab dose intensification in adult and pediatric @entity1 with @entity30 . Studies were identified through the electronic databases of MEDLINE and the annual meetings of @entity21149 Week, of the United European Gastroenterology Week, and of the American College of Gastroenterology and the European Crohn's and @entity1960 Organization meetings. Studies evaluating loss of efficacy and/or need for dose intensification were included. Thirty-nine studies were included. The mean percentage of loss of response to adalimumab among primary responders was 18.2% and the annual risk was 20.3% per @entity1 -year. The mean percentage of @entity1 who required dose intensification among primary responders to adalimumab was 37% and the annual risk was 24.8% per @entity1 -year. When considering initial responders and @entity1 with primary non-response, the mean percentage of @entity1 who needed an adalimumab dose escalation was 21.4% and the annual risk was 24.4% per @entity1 -year. Pooled analysis showed that dose escalation permitted response to be regained in 71.4% and remission in 39.9% of @entity1 . Predictors for loss of response or dose escalation were male gender, current/former smoker status, family history of @entity29 , isolated @entity1049 , extra-intestinal manifestations, 80/40    mg induction therapy, longer disease duration, greater baseline @entity30 Activity Index, concomitant corticosteroid use, no deep remission at week 12, low serum trough concentrations of adalimumab, previous infliximab non-response and being previously treated with an anti- @entity5 @entity39 factor agent. Overall, around one fifth of adult @entity1 require dose intensification and experience a loss of response after initiation of adalimumab therapy. Adalimumab dose escalation permits response to be regained in the majority of @entity1 .

Loss of response and need for adalimumab dose intensification in XXXX : a systematic review.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity39 :: ('MESH:D009336', 'Disease') :: ['necrosis'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor'] @entity29 :: ('MESH:D015212', 'Disease') :: ['inflammatory bowel disease'] @entity1960 :: ('MESH:D003092', 'Disease') :: ['Colitis'] @entity21149 :: ('MESH:D004066', 'Disease') :: ['Digestive Disease'] @entity30 :: ('MESH:D003424', 'Disease') :: ["Crohn's Disease", "Crohn's disease"] @entity1049 :: ('MESH:D003108', 'Disease') :: ['colonic disease']
@entity30 :: (MESH:D003424,Disease) :: ['Crohn's disease']
