Adalimumab and Infliximab in Crohn's disease - real life data from a national retrospective cohort study

• Published in: Current health sciences journal Vol. 42; no. 2; pp. 115 - 124
• Main Authors: Preda, C, Fulger, L, Gheorghe, L, Gheorghe, C, Goldis, A, Trifan, A, Tantau, M, Tantau, A, Negreanu, L, Manuc, M, Cijevschi-Prelipcean, C, Iacob, R, Tieranu, C, Meianu, C, Diculescu, M
• Format: Journal Article
• Language: English
• Published: Romania Medical University Publishing House Craiova 01-04-2016
• Subjects: Original Paper; Infliximab; Adalimumab; Crohn's disease
• ISSN: 2067-0656; 2069-4032
• DOI: 10.12865/CHSJ.42.02.01

to compare the efficacy and safety of Adalimumab(ADA) and Infliximab(IFX), in a large Romanian population and to identify predictors of response. Methods We performed a national retrospective cohort study including 265 patients (136 ADA, 129 IFX) between 2008-2014. Binary logistic regression was performed with the statistical program Minitab.
Patients were half women, with a median age of 36, a median disease duration of 2.5 years, 80% received Azathioprine. Mean therapy duration was 20 months in ADA group and 36 months in IFX group. Complete response to Adalimumab respectively Infliximab was recorded in 77%vs.65%, secondary loss of response in 18%vs.28%, statistically comparable. We failed to identify predictors of response. In 79.2%of patients with secondary loss of response to ADA, the dose was escalated, 12.5% were switched to Infliximab. In 70%of patients that lost response to IFX, the dose was increased, 30% were switched to Adalimumab.
Adalimumab and Infliximab have similar efficacy, with a complete response rate of~70%. In case of secondary loss of response to IFX, the best solution is to switch to ADA, with 83% response rate, while in case of secondary loss of response to ADA, increasing the dose leads to 84 % response rate.