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

Abstract

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 (n = 44) or adalimumab (n = 49). In the infliximab group, the induction was completed by 77.3% of patients, due to no response (n = 2), delayed hypersensitivity reactions (DHR) or infusion reactions (n = 8). Maintenance with infliximab was completed by 60% of patients, due to clinical worsening or loss of efficacy (n = 5), DHR or infusion reactions (n = 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 (n = 8), DHR (n = 1), other causes (n = 7). In both groups, the CDAI significantly reduced at baseline vs. each visit (P < 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 P = 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), P = 0.001] and non stricturing non penetrating behaviour [HR = 3.116 (1.06-9.13), P = 0.03826].

CONCLUSIONS:

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

• Authors: F Zorzi, S Zuzzi, S Onali, E Calabrese, G Condino, C Petruzziello, M Ascolani, F Pallone, L Biancone
• Journal: Alimentary pharmacology & therapeutics (Aliment Pharmacol Ther) Vol. 35 Issue 12 Pg. 1397-407 (Jun 2012) ISSN: 1365-2036 [Electronic] England
• PMID: 22519466 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2012 Blackwell Publishing Ltd.

Chemical References

• Anti-Inflammatory Agents
• Antibodies, Monoclonal
• Antibodies, Monoclonal, Humanized
• Tumor Necrosis Factor-alpha
• Infliximab
• Adalimumab

Topics

• Adalimumab
• Adult
• Aged
• Anti-Inflammatory Agents (adverse effects, therapeutic use)
• Antibodies, Monoclonal (adverse effects, therapeutic use)
• Antibodies, Monoclonal, Humanized (adverse effects, therapeutic use)
• Crohn Disease (drug therapy)
• Female
• Humans
• Infliximab
• Kaplan-Meier Estimate
• Longitudinal Studies
• Male
• Middle Aged
• Proportional Hazards Models
• Treatment Outcome
• Tumor Necrosis Factor-alpha (antagonists & inhibitors)
• Young Adult