Treatment Persistence for Infliximab Versus Adalimumab in Crohnʼs Disease

Olivera, Pablo; Thiriet, Linda; Luc, Amandine; Baumann, Cédric; Danese, Silvio; Peyrin–Biroulet, Laurent

doi:10.1097/mib.0000000000001072

Cited by 38 publications

(48 citation statements)

References 28 publications

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“…The short‐term efficacy, including achievement of steroid‐free remission, and the continuation of the first anti‐TNF agent were similar between the patients treated with IFX first and those treated with ADA first, and these results were consistent with those reported in previous studies . The similarity of our patient characteristics and short‐term outcomes with those in previous studies suggests a high level of confidence in the quality of our long‐term outcome analysis, which is the highlight of the current study.…”

Section: Discussionsupporting

confidence: 89%

“…Most of the previous reports examined only the clinical course up to the first LOR, which can occur in more than 5% of patients per year, and those were insufficient for the evaluation of disease course in patients with CD. A few reports evaluated long‐term outcomes over 2 years, but the difference in long‐term outcomes according to the type of the first anti‐TNF agent was not discussed. Even if head‐to‐head prospective comparisons existed, it would be very difficult to evaluate long‐term outcomes over years.…”

Section: Discussionmentioning

confidence: 99%

“…No head‐to‐head comparisons have been performed regarding which agent, IFX or ADA, should be administered first for biologic‐naïve CD patients. Therefore, several retrospective and a few prospective studies have compared the rates of clinical or steroid‐free remission, surgery, loss of response (LOR), and adverse events between patients who received IFX first and those who received ADA first . However, most of these previous reports evaluated relatively short‐term outcomes only and discontinued observation of patient clinical courses at the first episode of LOR.…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, several retrospective and a few prospective studies have compared the rates of clinical or steroid-free remission, surgery, loss of response (LOR), and adverse events between patients who received IFX first and those who received ADA first. [2][3][4][5][6][7][8][9][10][11][12][13][14] However, most of these previous reports evaluated relatively short-term outcomes only and discontinued observation of patient clinical courses at the first episode of LOR. Therefore, long-term outcomes of the patients who were administered each agent as the first-line biologic have scarcely been reported.…”

Section: Introductionmentioning

confidence: 99%

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Long‐term outcomes of patients with Crohn's disease who received infliximab or adalimumab as the first‐line biologics

Inokuchi

Takahashi

Hiraoka

et al. 2019

J of Gastro and Hepatol

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Background and Aim Although previous studies compared the efficacy of infliximab (IFX) versus adalimumab (ADA) as the first‐line biologics for Crohn's disease (CD), the difference in long‐term prognosis based on which biologic was used first has scarcely been reported. In particular, the clinical courses after loss of response (LOR) of the first‐line biologics are largely unknown. Methods A multicenter, retrospective study was performed. Disease courses of biologic‐naïve CD patients who were started on IFX or ADA treatment were evaluated, even after LOR of the initial biologics. Results In total, 263 CD patients were eligible for analysis, 183 were treated with IFX first, and 80 were treated with ADA first. The median observation period was 64.2 months. The cumulative steroid‐free remission rates and surgery‐free rates did not differ significantly between the patients treated with IFX first and those treated with ADA first (log‐rank test P = 0.42 and P = 0.74, respectively). In addition, no significant difference was observed in the rate of occurrence of events associated with ineffectiveness (modification of anti‐tumor necrosis factor treatment including intensification, switch, discontinuation, or surgery) between the patient groups (log‐rank test P = 0.62). The patients treated with IFX first were likely to discontinue the agent due to adverse events, whereas those treated with ADA first were likely to discontinue due to treatment failure or LOR. Conclusions No significant difference was observed in the long‐term prognosis between biologic‐naïve patients with CD who were started treatment with IFX first and ADA first.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Long‐term outcomes of patients with Crohn's disease who received infliximab or adalimumab as the first‐line biologics

Inokuchi

Takahashi

Hiraoka

et al. 2019

J of Gastro and Hepatol

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“…Of note, both SpA and IBD are characterized by the presence of sex differences in their onset, progression and response to therapy (Rusman et al, 2018a,b; Shah et al, 2018). Regarding TNFi, differences between males and females in response to these drugs have recently been suggested, with males responding better than females (Gonzalez-Lama et al, 2008a,b; Olivera et al, 2017; Rusman et al, 2018a,b). However, the relationship between sex and response to TNFi in SpA and IBD is far to be fully elucidated.…”

Section: Introductionmentioning

confidence: 99%

Sex Differences in Response to TNF-Inhibiting Drugs in Patients With Spondyloarthropathies or Inflammatory Bowel Diseases

et al. 2019

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Spondyloarthritis (SpA) and inflammatory bowel diseases (IBD) are chronic inflammatory diseases characterized by an aberrant immune response and inflammation with a key role for TNF in their pathogenesis. Accordingly, TNF-inhibiting therapy (TNFi) has dramatically improved the management of these diseases. However, about 30% of patients discontinue TNFi for lack of response, loss of response, and side effects and/or adverse events. Thus, the possibility to identify in advance those patients who will have a good response to TNFi would be extremely beneficial. The aim of this study was to investigate differences between males and females with either SpA or IBD in response to TNFi molecules, i.e., infliximab (IFX) and adalimumab (ADA), considering the reasons for TNFi withdraw. Data of 594 patients, 349 with IBD (M/F: 194/155) and 245 with SpA (M/F: 123/122), previously unexposed to TNFi, were collected. In the IBD group, the rate of female patients discontinuing ADA was significantly higher than that of male patients (p = 0.03). No difference emerged according to the distribution of reason for discontinuation. Otherwise, a similar discontinuation rate between female and male patients receiving IFX therapy was observed. In the SpA group, the overall discontinuation rate was not different between males and females both for ADA and IFX. However, in patients treated with ADA, males interrupted therapy more frequently than females due to lack of response (p = 0.03). In conclusion, the assessment of sex differences in TNFi response could help physicians personalize the therapeutic approach in a sex-oriented perspective.

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Treatment escalation and de-escalation decisions in Crohn’s disease: Delphi consensus recommendations from Japan, 2021

et al. 2023

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Background We aimed to develop criteria for treatment intensification in patients with (1) luminal Crohn’s disease (CD), (2) CD with perianal disease and/or fistula, (3) CD with small bowel stenosis, (4) in the postoperative setting, and (5) for discontinuing or reducing the dose of treatment in patients with CD. Methods PubMed and Embase were searched for studies published since 1998 which may be relevant to the five defined topics. Results were assessed for relevant studies, with preference given to data from randomized, controlled studies. For each question, a core panel of 12 gastroenterologists defined the treatment target and developed statements, based on the literature, current guidelines, and relevant additional studies. The evidence supporting each statement was graded using the Oxford Centre for Evidence-Based Medicine: Levels of Evidence (March 2009). A modified Delphi process was used to refine statements and gain agreement from 54 Japanese specialists at in-person and online meetings conducted between October 2020 and April 2021. Results Seventeen statements were developed for treatment intensification in luminal CD (targeting endoscopic remission), six statements for treatment intensification in perianal/fistulizing CD (targeting healing of perianal lesions and complete closure of the fistula), six statements for treatment intensification in CD with small bowel stenosis (targeting resolution of obstructive symptoms), seven statements for treatment intensification after surgery (targeting endoscopic remission), and five statements for discontinuing or reducing the dose of treatment in patients with CD. Conclusions These statements provide guidance on how and when to intensify or de-intensify treatment for a broad spectrum of patients with CD.

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Treatment Persistence for Infliximab Versus Adalimumab in Crohnʼs Disease

Abstract: IFX and ADA show similar levels of persistence as first- and second-line anti-TNF treatments. Female sex and stricturing behavior were associated with poor persistence of first-line treatments, whereas age was the only factor associated with poor persistence of second-line treatments.

Cited by 38 publications

References 28 publications

Long‐term outcomes of patients with Crohn's disease who received infliximab or adalimumab as the first‐line biologics

Long‐term outcomes of patients with Crohn's disease who received infliximab or adalimumab as the first‐line biologics

Sex Differences in Response to TNF-Inhibiting Drugs in Patients With Spondyloarthropathies or Inflammatory Bowel Diseases

Treatment escalation and de-escalation decisions in Crohn’s disease: Delphi consensus recommendations from Japan, 2021

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