Long-term real-life efficacy and safety of infliximab and adalimumab in the treatment of inflammatory bowel diseases outpatients.

Abstract

BACKGROUND:

Infliximab and adalimumab are widely used for the treatment of Crohn's disease and ulcerative colitis.

AIM:

To compare the long-term efficacy and safety of infliximab and adalimumab in a large cohort of Crohn's disease and ulcerative colitis patients reflecting real-life clinical practice.

METHODS:

Seven hundred twelve patients were retrospectively reviewed, 410 with Crohn's disease (268 treated with adalimumab and 142 with infliximab; median follow-up 60 months, range, 36-72) and 302 with ulcerative colitis (118 treated with adalimumab and 184 with infliximab; median follow-up 48 months, range, 36-84).

RESULTS:

In Crohn's disease, clinical remission was maintained in 75.0% of adalimumab vs. in 72.5% of infliximab patients (P = 0.699); mucosal healing and steroid-free remission were maintained in 49.5% of adalimumab vs. 63.9% of infliximab patients (P = 0.077) and in 77.7% of adalimumab vs. 77.3% in infliximab group (P = 0.957), respectively. In ulcerative colitis, clinical remission was maintained in 50.0% of adalimumab vs. 65.8% of infliximab patients (P < 0.000); mucosal healing and steroid-free remission were maintained in 80.6% of adalimumab vs. 77.0% of infliximab patients (P = 0.494) and in 90.2% of adalimumab vs. 87.5% of infliximab patients (P = 0.662), respectively. At the multivariate analysis, ileocolonic location and simple endoscopic score for Crohn's disease >10 were predictors of failure in Crohn's disease; treatment with adalimumab, BMI ≥30 and Mayo score >10 were predictors of failure in ulcerative colitis. infliximab was more likely to cause adverse events than adalimumab (16.6 vs. 6.2%, P < 0.000).

CONCLUSION:

Both adalimumab and infliximab are effective in long-term outpatients management of inflammatory bowel diseases. Adalimumab had a lower rate of adverse events.

• Authors: Antonio Tursi, Giammarco Mocci, Roberto Lorenzetti, Leonardo Allegretta, Giovanni Brandimarte, Claudio Cassieri, Raffaele Colucci, Antonio De Medici, Roberto Faggiani, Antonio Ferronato, Serafina Fiorella, Giacomo Forti, Marilisa Franceschi, Sara Gallina, GianMarco Giorgetti, Giuseppina Grasso, Tiziana Larussa, Francesco Luzza, Antonio Penna, Roberta Pica, Simona Piergallini, Sarah Porciello, Giuseppe Pranzo, Stefano Rodino', Stefano Scorza, Ladislava Sebkova, Costantino Zampaletta, Walter Elisei, Marcello Picchio
• Journal: European journal of gastroenterology & hepatology (Eur J Gastroenterol Hepatol) Vol. 33 Issue 5 Pg. 670-679 (05 01 2021) ISSN: 1473-5687 [Electronic] England
• PMID: 33741797 (Publication Type: Journal Article)
• Copyright: Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.

Chemical References

• Tumor Necrosis Factor-alpha
• Infliximab
• Adalimumab

Topics

• Adalimumab (adverse effects, therapeutic use)
• Colitis, Ulcerative (drug therapy)
• Crohn Disease (drug therapy)
• Humans
• Infliximab (adverse effects, therapeutic use)
• Outpatients
• Retrospective Studies
• Treatment Outcome
• Tumor Necrosis Factor-alpha