Effects of Adalimumab, Infliximab in Biologic-Naive IBD Patients

The following article is a part of conference coverage from the 2019 Advances in Inflammatory Bowel Diseases (AIBD) Meeting, being held in Orlando, Florida. The team at MPR will be reporting on the latest news and research conducted by leading experts gastroenterology. Check back for more from the 2019 AIBD Meeting.


ORLANDO – Treatment with adalimumab (ADA) or infliximab (IFX) in biologic-naive patients with Crohn disease (CD) or ulcerative colitis (UC) demonstrated similar outcomes on Patient-Reported Outcomes Measurement Information System (PROMIS) measures and rates of corticosteroid-free remission, according to data presented at the 2019 Advances in Inflammatory Bowel Diseases (AIBD) Annual Meeting, held December 12-14, 2019 in Orlando, FL. 

In order to determine the effects of initiation of ADA or IFX in biologic-naive patients with inflammatory bowel disease (IBD) on PROMIS measures and corticosteroid-free remission, investigators conducted longitudinal and bivariate analyses utilizing data from IBD Partners Cohort. Effects on PROMIS measures of anxiety, depression, fatigue, pain, sleep, and social satisfaction, as measured in T-scores, were compared between the two treatment groups. Steroid-free remission rates, defined as lack of steroid use at follow-up and short Crohn’s Disease Activity Index (sCDAI) <150 or Simple Clinical Colitis Activity Index (SCCAI) ≤2, were also compared and analyzed.

Investigators found comparative outcomes between ADA and IFX treatment, with both biologics showing similar effects on PROMIS measures and similar rates of corticosteroid-free remission in biologic-naive CD and UC patients. No statistically significant differences in the proportion of patients with PROMIS T-score <55 on measures of anxiety, depression, fatigue, pain, and sleep, and T-score >45 for social satisfaction in both treatment groups. Steroid-free remission occurred in 47.7% of patients in the IFX group, compared with 56.3% of patients in the ADA group (P =.193). A predictor for corticosteroid-free remission was the lack of steroid use at baseline in CD patients, while no predictive factors were found in UC patients. 

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Adalimumab and infliximab are two of the most common anti-tumor necrosis factor (TNF) biologics used for the treatment of IBD. They are currently indicated for the treatment of CD and UC in patients with inadequate response to conventional therapies (eg, corticosteroids, immunomodulators). 

Reference:

Weaver KN, Curtis J, Beukelman T, et al. Use of Infliximab or Adalimumab in Biologic-Naive Patients with Inflammatory Bowel Disease: A Study of Patient Reported Outcomes in IBD Partners. Presented at the 2019 AIBD Annual Meeting on December 12-14 in Orlando, FL.