Effectiveness and safety of infliximab and adalimumab for ambulatory Crohn's disease patients in primary gastroenterology centres

Eur J Intern Med. 2014 Jun;25(5):485-90. doi: 10.1016/j.ejim.2014.02.010. Epub 2014 Mar 13.

Abstract

Background: Infliximab (IFX) and adalimumab (ADA) are the key treatments for Crohn's Disease (CD), unresponsive to standard treatments. Our aim was to compare the efficacy and safety of IFX and ADA in treating CD in clinical practice.

Methods: One hundred and twenty-six patients (61 M, 65 F, mean age 36.2 years, range 19-67 years), affected by CD, were treated with infliximab (IFX, 59 patients) or adalimumab (ADA, 66 patients). Clinical efficacy, mucosal healing (MH), histological healing (HH), and safety were assessed. MH was defined complicated if healing of ulcers occurred with deformation of bowel profile and/or complete colonoscopy was impossible because of scars.

Results: Patients were followed-up for 36 months. No difference was found between IFX and ADA in maintaining long-term clinical remission, MH and HH. Complicated MH was present in 17 (28.8%) patients in IFX group and in 7 (10.6%) patients in ADA group (p=0.012). In 9 (15.2%) patients in IFX group and 2 (3.0%) patients in ADA group colonoscopy was incomplete without cecal intubation or terminal ileum exploration (p=0.024). Side effects were similar in both groups.

Conclusions: Both IFX and ADA seem to be effective and safe in long-term outpatient treatment of CD in clinical practice.

Keywords: Anti-TNFα; Clinical practice; Clinical remission; Crohn's disease; Histological healing; Mucosal healing.

Publication types

  • Comparative Study

MeSH terms

  • Adalimumab
  • Adult
  • Aged
  • Ambulatory Care
  • Anti-Inflammatory Agents / therapeutic use*
  • Antibodies, Monoclonal / therapeutic use*
  • Antibodies, Monoclonal, Humanized / therapeutic use*
  • Crohn Disease / drug therapy*
  • Crohn Disease / pathology
  • Female
  • Humans
  • Infliximab
  • Intestinal Mucosa / drug effects
  • Intestinal Mucosa / pathology
  • Male
  • Middle Aged
  • Remission Induction
  • Treatment Outcome
  • Tumor Necrosis Factor-alpha
  • Young Adult

Substances

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