Comparative effectiveness of infliximab and adalimumab for Crohn's disease

Clinical Gastroenterology and Hepatology , 04/21/2014

This study compared the effectiveness of infliximab and adalimumab, the 2 most commonly used anti–tumor necrosis factor agents, in patients with Crohn's disease (CD). The authors observed similar effectiveness of infliximab and adalimumab for CD on the basis of 3 clinically important outcome measures.


  • The authors conducted a retrospective cohort study by using U.S. Medicare data from 2006 through 2010.
  • Patients with CD who were new users of infliximab (n = 1459) or adalimumab (n = 871) after January 31, 2007, were included.
  • Patients older than age 85 and those with rheumatoid arthritis, psoriasis, psoriatic arthritis, or ankylosing spondylitis were excluded.
  • The primary outcome measures were disease persistence on therapy at week 26, surgery (including bowel resection, creation of an ostomy, or surgical treatment of a perforation or abscess), and hospitalization for CD.
  • Propensity score-adjusted logistic and Cox regression were used to compute adjusted odds ratios or hazard ratios and 95% confidence intervals (CIs).


  • After 26 weeks of treatment, 49% of patients receiving infliximab remained on drug, compared with 47% of those receiving adalimumab (odds ratio, 0.98; 95% CI, 0.81–1.19).
  • Fewer patients treated with infliximab underwent surgery than those treated with adalimumab, but this difference was not statistically significant (5.5 vs 6.9 surgeries per 100 person-years; hazard ratio, 0.79; 95% CI, 0.60–1.05).
  • Rates of hospitalization did not differ between groups (hazard ratio, 0.88; 95% CI, 0.72–1.07).

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