From the Guidelines
For a Crohn's disease patient in remission on weekly Humira, 6-month check-ups should include a comprehensive clinical assessment, laboratory tests, and monitoring for potential complications, as these regular check-ups are crucial for maintaining remission and preventing disease progression.
Key Components of 6-Month Check-Ups
- A comprehensive clinical assessment including a detailed discussion of any symptoms (abdominal pain, diarrhea, weight changes, fatigue), medication side effects, and quality of life measures, as symptoms should be assessed at each visit, with the frequency of visits dependent on the patient's treatment regimen, but typically every 3–6 months 1.
- Laboratory tests should include complete blood count, liver function tests, kidney function tests, inflammatory markers (C-reactive protein and/or fecal calprotectin), and therapeutic drug monitoring of Humira levels and antibodies if available, as these tests are essential for monitoring treatment side effects and detecting early disease recurrence 1.
- Periodic colonoscopies are typically recommended every 1-3 years even during remission to assess mucosal healing, as endoscopic remission is associated with a reduced risk of relapse 1.
- Monitoring for potential Humira-related complications including checking for tuberculosis exposure (annually), skin examinations for melanoma, and assessment for neurological symptoms, as these complications can have a significant impact on morbidity and mortality.
- Vaccination status should be reviewed, particularly avoiding live vaccines while on Humira, to prevent potential infections.
- Nutritional assessment may be performed if there are concerns about malabsorption, as malabsorption can lead to significant morbidity and impact quality of life.
Importance of Regular Check-Ups
Regular check-ups are crucial for detecting early disease recurrence before symptoms appear, monitoring medication effectiveness, identifying potential complications, and adjusting treatment as needed to maintain remission and prevent disease progression. By prioritizing these key components, healthcare providers can help improve morbidity, mortality, and quality of life outcomes for patients with Crohn's disease.
From the Research
Overview of 6-Month Check-Ups for Crohn's Disease Patients on Humira
- Patients with Crohn's disease on weekly Humira (adalimumab) should have regular check-ups to monitor their condition and adjust treatment as needed 2, 3, 4.
- The check-ups should include assessments of clinical remission, response to treatment, and any adverse events 2, 5, 6.
Monitoring of Laboratory Parameters
- Laboratory parameters such as albumin, hemoglobin, and C-reactive protein should be monitored to assess the effectiveness of adalimumab treatment 3.
- Improvements in these laboratory parameters have been associated with clinical remission and response to treatment 3.
Adalimumab Trough Serum Levels and Anti-Adalimumab Antibodies
- Adalimumab trough serum levels and anti-adalimumab antibodies should be monitored to assess the long-term clinical outcome of patients with Crohn's disease 5, 6.
- Higher adalimumab trough serum levels have been associated with clinical remission, while the presence of anti-adalimumab antibodies has been associated with lower trough levels and reduced treatment efficacy 5, 6.