Patients with Crohn’s disease are now usually injected with 40 mg of adalimumab every two weeks. At this usual dose, inflammatory flare-ups do not occur in 85% to 90% of patients. If they stop taking this medication, at least half will have another flare-up, but until now it was unknown what would happen if patients took less of the drug, the researchers said.
The majority of patients who received 40 mg adalimumab every four weeks (instead of every two) during this study had disease control. In only a small proportion of the patients, the inflammations flared up more often than with the usual administration, and some patients experienced slightly more complaints, but these were also quickly under control.
Patients can therefore consider extending the time between doses, if properly guided by their own doctor, conclude the researchers, who published their results in The Lancet Gastroenterology.
Fewer infections
According to the researchers, this study shows that spraying less often has benefits. For example, patients who taper off have fewer infections, possibly because the immune system is suppressed less often. They also have less pain at the injection site, and more frequent injections remind patients of their illness. It also saves costs if patients use the medicine less often.
According to the researchers, it is desirable for some of the patients to reduce their medication, for example because they suffer from the side effects or find it difficult to take the injections with them on holiday. Also, certain vaccinations cannot be given in combination with adalimumab. Patients therefore want to know whether they can safely reduce their use of the medicine.
Clinical practice
The study has been a process of almost nine years, in which twenty hospitals participated. In the 174 patients in this study, the disease had been stable for some time before the start of the study. The patients are all supervised by their own doctor.
Because the study was carried out in practice, the researchers state that the results can be easily applied in clinical practice. In a follow-up study, the researchers will calculate exactly how much money it can save if patients use less of the drug adalimumab.