Prospective comparison of preference and efficacy of adalimumab and infliximab for treating ulcerative colitis naive to antitumor necrosis factor therapy

Abstract

There have been few reports on 2 tumor necrosis factor alpha inhibitors, infliximab and adalimumab, with respect to patient preference and efficacy in ulcerative colitis (UC).We used questionnaires to evaluate the preference and reasons for drug choice between infliximab and adalimumab in UC patients naive to antitumor necrosis factor alpha therapy. We also analyzed the efficacy of infliximab and adalimumab prospectively and endoscopically before treatment and at 14 and 54 weeks.Of the 25 UC patients, infliximab and adalimumab were chosen by 10 (40%) and 15 (60%), respectively. Patients who favored infliximab considered “fear of syringes” (7/10, 70%) as the most important influencing factor, whereas patients who favored adalimumab considered “ease of administration” (10/15, 66.7%) and “time required for therapy” (10/15, 66.7%) as the most important factors. There were no statistical differences in remission induction and maintenance between the infliximab and adalimumab groups with regard to response, remission, mucosal healing, steroid-free, and steroid-free remission rates at weeks 14 and 54.The efficacy of adalimumab in remission induction and maintenance was equivalent to that of infliximab in UC patients naive to antitumor necrosis factor alpha therapy in this prospective study, but more patients preferred adalimumab.

Long-term Outcomes of Adalimumab Therapy in Korean Patients with Ulcerative Colitis: A Hospital-Based Cohort Study

“…Furthermore, as our study was conducted in reallife setting, assessment of clinical response might have been less stringent compared to a placebo-controlled trial and a prospective study from Japan. 8,9,19 Partial Mayo score after 8 weeks of adalimumab therapy was found to be associated with discontinuing maintenance therapy in our study. Likewise, a previous Spanish study reported that a lack of response at week 12 was associated with an increased probability of discontinuing adalimumab and a higher rate of colectomy.…”

“…8,9 In another prospective study from Japan, 73.3% of UC patients responded to adalimumab therapy at week 14 in 15 anti-TNF-naïve UC patients. 19 Furthermore, the drop-out rate before week 54 was 40% (6/15) and the response, remission, and mucosal healing rates at week 54 were 66.7%, 53.3%, and 58.3%, respectively. 19 In our study, 92% of patients entered into adalimumab maintenance therapy and the cumulative rate of maintaining adalimumab therapy until 1 year was 70.0% among the patients who received adalimumab therapy for 8 weeks or more.…”

“…19 Furthermore, the drop-out rate before week 54 was 40% (6/15) and the response, remission, and mucosal healing rates at week 54 were 66.7%, 53.3%, and 58.3%, respectively. 19 In our study, 92% of patients entered into adalimumab maintenance therapy and the cumulative rate of maintaining adalimumab therapy until 1 year was 70.0% among the patients who received adalimumab therapy for 8 weeks or more. These figures seem to be higher when comparing with the results presented by the previously mentioned Japanese studies.…”

“…These figures seem to be higher when comparing with the results presented by the previously mentioned Japanese studies. 8,9,19 However, this difference might be brought about because of different outcome definitions. Furthermore, as our study was conducted in reallife setting, assessment of clinical response might have been less stringent compared to a placebo-controlled trial and a prospective study from Japan.…”

Comparative efficacy of antitumor necrosis factor agents and tacrolimus in naïve steroid-refractory ulcerative colitis patients

“…Considering the data for the IFX and ADA subgroups, we did not see any differences in overall efficiency in 8 weeks. Mizoshita et al 31 showed that the efficacy of ADA in remission induction was also equivalent to that of IFX in UC patients who had not previously used anti-TNF agents. Contrarily, a recent indirect comparison meta-analysis 32 and network meta-analysis 33,34 showed that IFX is superior to ADA in the induction of remission in UC patients.…”