Infliximab vs. adalimumab in Crohn's disease: results from 327 patients in an Australian and New Zealand observational cohort study

Simple item page
dc.contributor.authorDoecke, J.
dc.contributor.authorHartnell, F.
dc.contributor.authorBampton, P.
dc.contributor.authorBell, S.
dc.contributor.authorMahy, G.
dc.contributor.authorGrover, Z.
dc.contributor.authorLewindon, P.
dc.contributor.authorJones, L.
dc.contributor.authorSewell, K.
dc.contributor.authorKrishnaprasad, K.
dc.contributor.authorProsser, R.
dc.contributor.authorMarr, D.
dc.contributor.authorFischer, J.
dc.contributor.authorR Thomas, G.
dc.contributor.authorTehan, J.
dc.contributor.authorDing, N.
dc.contributor.authorCooke, S.
dc.contributor.authorMoss, K.
dc.contributor.authorSechi, A.
dc.contributor.authorDe Cruz, P.
dc.contributor.authoret al.
dc.date.issued2017
dc.description.abstractMaintenance anti-tumour necrosis factor-α (anti-TNFα) treatment for Crohn's disease is the standard of care for patients with an inadequate response to corticosteroids and immunomodulators.To compare the efficacy and safety of infliximab and adalimumab in clinical practice and assess the value of concomitant immunomodulator therapy.We performed an observational cohort study in consecutive patients with Crohn's disease qualifying for anti-TNFα treatment in Australia and New Zealand between 2007 and 2011. Demographic and clinical data were prospectively recorded to identify independent factors associated with induction and maintenance of response to infliximab or adalimumab, or to either anti-TNFα therapy.Three hundred and twenty-seven patients (183 infliximab, 144 adalimumab) successfully applied for treatment. Eighty-nine percent responded in all groups and median maintenance of response was similar for the two agents. Concomitant immunomodulator with infliximab, but not adalimumab, demonstrated a significantly longer response overall (P = 0.002), and significantly fewer disease and treatment-related complications (P = 0.017). Corticosteroids at baseline, and/or in the preceding 12 months, were associated with a 9-13 times greater risk of disease flare during maintenance treatment as compared to no corticosteroids (P < 0.0001). Maintenance of response was similar in the anti-TNF naïve and anti-TNF experienced subgroups.In this large, real-life study, we demonstrate infliximab and adalimumab to have similar response characteristics. However, infliximab requires concomitant immunomodulator to achieve optimal maintenance of response comparable to adalimumab monotherapy. The results of this study will assist clinicians in further optimising patient care in their day-to-day clinical practice.
dc.description.statementofresponsibilityJ. D. Doecke ... J. M. Andrews ... On behalf of the Australian and New Zealand Inflammatory Bowel Disease Consortium, et al.
dc.identifier.citationAlimentary Pharmacology and Therapeutics, 2017; 45(4):542-552
dc.identifier.doi10.1111/apt.13880
dc.identifier.issn0269-2813
dc.identifier.issn1365-2036
dc.identifier.orcidAndrews, J. [0000-0001-7960-2650]
dc.identifier.urihttp://hdl.handle.net/2440/104362
dc.language.isoen
dc.publisherBlackwell Publishing Inc.
dc.rights© 2016 John Wiley & Sons Ltd
dc.source.urihttps://doi.org/10.1111/apt.13880
dc.subjectAustralian and New Zealand Inflammatory Bowel Disease Consortium
dc.titleInfliximab vs. adalimumab in Crohn's disease: results from 327 patients in an Australian and New Zealand observational cohort study
dc.typeJournal article
pubs.publication-statusPublished

Files

Collections

Medicine publications