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A retrospective comparison of infliximab versus adalimumab as induction and maintenance therapy for Crohn disease
Author(s) -
Varma P.,
Paul E.,
Huang C.,
Headon B.,
Sparrow M. P.
Publication year - 2016
Publication title -
internal medicine journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 1444-0903
DOI - 10.1111/imj.13040
Subject(s) - medicine , infliximab , adalimumab , crohn's disease , retrospective cohort study , refractory (planetary science) , adverse effect , maintenance therapy , dosing , surgery , fistula , gastroenterology , disease , chemotherapy , physics , astrobiology
Background In Australia, infliximab ( IFX ) and adalimumab ( ADA ) are available for the treatment of moderate–severe Crohn disease (CD) refractory to conventional therapies, with minimal local data comparing their efficacy. Aim The aim of this study was to compare clinical and biochemical outcomes at 3 and 12 months between patients receiving induction and maintenance therapy with IFX versus ADA . Methods Retrospective single‐centre audit of all patients commenced on IFX or ADA as their first anti‐tumour necrosis factor agent between July 2007 and May 2012. Clinical and biochemical parameters were compared pre‐commencement, 3 and 12 months post‐commencement. Results A total of 81 patients was included in the study; 63 IFX ‐treated and 18 ADA ‐treated. Significant Crohn disease activity index ( CDAI ) reductions were noted within both groups at 3 months ( P < 0.001) and 12 months ( P < 0.001). Similarly, significant reductions were noted in steroid doses within groups at 3 months ( P < 0.05) and 12 months ( P < 0.05), with notable reductions in C‐reactive protein ( CRP ) at 3 months within groups ( P < 0.05). Adverse events occurred in 14.3% of IFX and 11.1% of ADA patients. Comparing IFX with ADA , no difference was shown between groups in CDAI reductions at 3 months ( P = 0.94) and 12 months ( P = 0.95), steroid dosing at 3 months ( P = 0.23) and 12 months ( P = 0.81), and CRP reduction at 3 months ( P = 0.33) and 12 months ( P = 0.62). Fistula‐related admissions were significantly reduced in IFX patients (100% reduction post‐ IFX vs 66.7% post‐ ADA ) ( P = 0.01). Conclusion Clinical and biochemical outcomes were similar in patients treated with IFX or ADA as induction and maintenance therapy for CD. However, significant reductions were noted in admissions relating to fistulising disease in IFX patients.