Efficacy and safety of infliximab and adalimumab in Crohns disease: a single centre study
Alimentary Pharmacology and Therapeutics, 04/25/2012
Zorzi F et al. – Infliximab and adalimumab showed a similar efficacy. No smoking and non–stricturing non–penetrating behaviour were predictors of steroid–free remission.Methods
- In a longitudinal study, CD patients with indication for anti-TNFs were treated with infliximab or adalimumab.
- 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].