Adalimumab Sustains Deep Remission for 3 Years: Data From CHARM and ADHERE
Bibliographic record
Abstract
Deep remission (DR), defined as clinical remission and mucosal healing (MH), has been associated with improved patient outcomes.1 Evidence of DR beyond 1 year has not been characterized. We aimed to evaluate the impact of adalimumab (ADA) on DR over a 3-year period. We analyzed the intention-to-treat (ITT) population from CHARM (56 weeks, randomized at Week 4 to placebo [PBO], ADA 40 mg every other week [eow], and ADA 40 mg weekly) and its 2-year open label extension ADHERE (all patients given open-label ADA 40 mg eow or weekly). Due to the absence of endoscopic measurements in CHARM and ADHERE, a practical index obtained from a Least Absolute Shrinkage and Selection Operator (LASSO) procedure was used to predict MH (defined as a CD Endoscopic Index of Severity [CDEIS] score ≤4.24). DR was defined as a Crohn's Disease Activity Index (CDAI) score <150 plus predicted MH. Patients who discontinued, had missing data, or switched to open-label therapy during CHARM were classified as DR nonresponders at subsequent time points. Rates of DR (assessed at Weeks 26 and 56) were compared between the ADA and PBO arms using chi-square tests. The rates of DR are also assessed in the open-label extension ADHERE (up to Week 164). Of 517 patients randomized to ADA in CHARM, 318 (62%) entered ADHERE. DR rates at Weeks 26 and 56 were significantly higher for the ADA eow and ADA weekly arms compared with PBO. Rates of DR on open-label ADA were maintained up to Week 164 during ADHERE (figure). DR was achieved by a substantial proportion of patients in CHARM. Rates of DR achievement were sustained over 3 years.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.009 | 0.010 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.003 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".