Original Articles: Gastroenterology

Long-term real-life efficacy and safety of infliximab and adalimumab in the treatment of inflammatory bowel diseases outpatients

Tursi, Antonio^a; Mocci, Giammarco^b; Lorenzetti, Roberto^c; Allegretta, Leonardo^d; Brandimarte, Giovanni^e; Cassieri, Claudio^e; Colucci, Raffaele^f; De Medici, Antonio^g; Faggiani, Roberto^h; Ferronato, Antonioⁱ; Fiorella, Serafina^j; Forti, Giacomo^k; Franceschi, Marilisaⁱ; Gallina, Sara^l; Giorgetti, GianMarco^m; Grasso, Giuseppina^d; Larussa, Tizianaⁿ; Luzza, Francescoⁿ; Penna, Antonio^o; Pica, Roberta^p; Piergallini, Simona^q; Porciello, Sarah^m; Pranzo, Giuseppe^r; Rodino’, Stefano^s; Scorza, Stefano^d; Sebkova, Ladislava^s; Zampaletta, Costantino^l; Elisei, Walter^h; Picchio, Marcello^t

Author Information

^aTerritorial Gastroenterology Service, ASL BAT, Andria

^bDivision of Gastroenterology, ‘Brotzu’ Hospital, Cagliari

^cDivision of Gastroenterology, ‘Nuovo Regina Margherita’ Territorial Hospital, Rome

^dDivision of Gastroenterology, ‘Santa Caterina Novella’ Hospital, Galatina (LE)

^eDivision of Internal Medicine and Gastroenterology, ‘Cristo Re’ Hospital, Rome

^fDigestive Endoscopy Unit, ‘San Matteo degli Infermi’ Hospital, Spoleto (PG)

^gTerritorial Gastroenterology Service, PST Catanzaro Lido, Catanzaro

^hDivision of Gastroenterology, ‘S. Camillo’ Hospital, Rome

ⁱDigestive Endoscopy Unit, ULSS7 Pedemontana, Santorso (VI)

^jDivision of Gastroenterology, ‘P. Pio Hospital’ Hospital, Vasto (CH)

^kDigestive Endoscopy Unit, ‘S. Maria Goretti’ Hospital, Latina

^lDivision of Gastroenterology, ‘Belcolle’ Hospital, Viterbo

^mDivision of Nutritional and Digestive Endoscopy, ‘S. Eugenio’ Hospital, Rome

ⁿDepartment of Health Science, University of Catanzaro, Catanzaro

^oTerritorial Gastroenterology Service, ASL BA, Bari

^pIBD Unit, Division of Gastroenterology, ‘S. Pertini’ Hospital, Rome

^qDivision of Gastroenterology, IBD Unit, ‘A. Murri’ Hospital, Fermo

^rAmbulatory for IBD Treatment, ‘Valle D’Itria’ Hospital, Martina Franca (TA)

^sDivision of Gastroenterology, ‘Ciaccio-Pugliese’ Hospital, Catanzaro

^tDivision of General Surgery, ‘P. Colombo’ Hospital, ASL Roma 6, Velletri (Roma), Italy

Received 21 April 2020 Accepted 7 June 2020

Correspondence to Antonio Tursi, MD, Territorial Gastroenterology Service, Via Torino, 49, 76123 Andria, Italy, Tel: +39 0883 551094; fax: +39 0883 1978210; e-mail: [email protected]

European Journal of Gastroenterology & Hepatology 33(5):p 670-679, May 2021. | DOI: 10.1097/MEG.0000000000002087

Abstract

Background

Infliximab and adalimumab are widely used for the treatment of Crohn’s disease and ulcerative colitis.

Aim

To compare the long-term efficacy and safety of infliximab and adalimumab in a large cohort of Crohn’s disease and ulcerative colitis patients reflecting real-life clinical practice.

Methods

Seven hundred twelve patients were retrospectively reviewed, 410 with Crohn’s disease (268 treated with adalimumab and 142 with infliximab; median follow-up 60 months, range, 36–72) and 302 with ulcerative colitis (118 treated with adalimumab and 184 with infliximab; median follow-up 48 months, range, 36–84).

Results

In Crohn’s disease, clinical remission was maintained in 75.0% of adalimumab vs. in 72.5% of infliximab patients (P = 0.699); mucosal healing and steroid-free remission were maintained in 49.5% of adalimumab vs. 63.9% of infliximab patients (P = 0.077) and in 77.7% of adalimumab vs. 77.3% in infliximab group (P = 0.957), respectively. In ulcerative colitis, clinical remission was maintained in 50.0% of adalimumab vs. 65.8% of infliximab patients (P < 0.000); mucosal healing and steroid-free remission were maintained in 80.6% of adalimumab vs. 77.0% of infliximab patients (P = 0.494) and in 90.2% of adalimumab vs. 87.5% of infliximab patients (P = 0.662), respectively. At the multivariate analysis, ileocolonic location and simple endoscopic score for Crohn’s disease >10 were predictors of failure in Crohn’s disease; treatment with adalimumab, BMI ≥30 and Mayo score >10 were predictors of failure in ulcerative colitis. infliximab was more likely to cause adverse events than adalimumab (16.6 vs. 6.2%, P < 0.000).

Conclusion

Both adalimumab and infliximab are effective in long-term outpatients management of inflammatory bowel diseases. Adalimumab had a lower rate of adverse events.

Article Keywords

Keywords
adalimumab, adverse events, anti-TNFα, clinical practice, clinical remission, Crohn’s disease, infliximab, ulcerative colitis

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Long-term real-life efficacy and safety of infliximab and adalimumab in the treatment of inflammatory bowel diseases outpatients