Efficacy and safety of infliximab and adalimumab in Crohn's disease: a single centre study

Authors


Correspondence to:

Prof. L. Biancone, Unità di Gastroenterologia, Dipartimento di Medicina Interna, Università di Roma, Tor Vergata, Via Montpellier 1, 00133 Rome, Italy.

E-mail: biancone@med.uniroma2.it

Summary

Background

Infliximab and adalimumab are highly effective in Crohn's Disease (CD). This is supported by clinical trials and open-label studies using either infliximab or adalimumab, thus not allowing a proper comparison between these anti-TNFs in CD.

Aim

To evaluate the efficacy and safety of infliximab and adalimumab in active CD.

Methods

In a longitudinal study, CD patients with indication for anti-TNFs were treated with infliximab or adalimumab.

Results

Ninety-three patients were treated with infliximab (= 44) or adalimumab (= 49). In the infliximab group, the induction was completed by 77.3% of patients, due to no response (= 2), delayed hypersensitivity reactions (DHR) or infusion reactions (= 8). Maintenance with infliximab was completed by 60% of patients, due to clinical worsening or loss of efficacy (= 5), DHR or infusion reactions (= 5). In the adalimumab group, all patients completed the induction, while maintenance was completed by 67% of patients, due to clinical worsening or loss of efficacy (= 8), DHR (= 1), other causes (= 7). In both groups, the CDAI significantly reduced at baseline vs. each visit (< 0.04). The Kaplan–Meier survival analysis performed to evaluate the risk of steroid-free remission in patients treated with infliximab vs. adalimumab detected no differences (log-rank test = 0.4). Cox proportional-hazards regression identified two predictors of steroid-free remission using anti-TNFs: no smokers [HR = 2.94 (1.52–5.70), = 0.001] and non stricturing non penetrating behaviour [HR = 3.116 (1.06–9.13), = 0.03826].

Conclusions

Infliximab and adalimumab showed a similar efficacy. No smoking and non-stricturing non-penetrating behaviour were predictors of steroid-free remission.

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