CHSJ

Curr Health Sci J, vol. 42, no. 2, 2016

Adalimumab and Infliximab in Crohn`s disease-real life data from a national retrospective cohort study

[Original Paper]

CARMEN PREDA(1), LARISA FULGER(1), LIANA GHEORGHE(1), C. GHEORGHE(1), A. GOLDIS(2), ANCA TRIFAN(3), M. TANTAU(4), ALINA TANTAU(4), L. NEGREANU(5), M. MANUC(1), CRISTINA CIJEVSCHI-PRELIPCEAN(3), R. IACOB(1), C. TIERANU(1), CORINA MEIANU(1), M. DICULESCU(1)


(1)Clinic Fundeni Institute, Gastroenterology & Hepatology, Bucharest,
(2)University of Medicine "Victor Babes", Clinic of Gastroenterology, Timisoara,
(3)Clinic County Hospital “Sf.Spiridon”, Gastroenterology and Hepatology, Iassy,
(4)Regional Institute of Gastroenterology and Hepatology “O.Fodor”, Gastroenterology and Hepatology, Cluj,
(5)Clinic Universitary Emergency Hospital, Bucharest


Abstract:

Aim: to compare the efficacy and safety of Adalimumab(ADA) and Infliximab(IFX), in a large Romanian population and to identify predictors of response. Methods We performed a national retrospective cohort study including 265 patients (136 ADA, 129 IFX) between 2008-2014. Binary logistic regression was performed with the statistical program Minitab. Results: Patients were half women, with a median age of 36, a median disease duration of 2.5 years, 80% received Azathioprine. Mean therapy duration was 20 months in ADA group and 36 months in IFX group. Complete response to Adalimumab respectively Infliximab was recorded in 77%vs.65%, secondary loss of response in 18%vs.28%, statistically comparable. We failed to identify predictors of response. In 79.2%of patients with secondary loss of response to ADA, the dose was escalated, 12.5% were switched to Infliximab. In 70%of patients that lost response to IFX, the dose was increased, 30% were switched to Adalimumab. Conclusions: Adalimumab and Infliximab have similar efficacy, with a complete response rate of~70%. In case of secondary loss of response to IFX, the best solution is to switch to ADA, with 83% response rate, while in case of secondary loss of response to ADA, increasing the dose leads to 84 % response rate.


Keywords: Adalimumab, Infliximab, Crohn`s disease



Corresponding: Preda Carmen- Monica, Clinic Fundeni Institute, Gastroenterology&Hepatology, Sos. Fundeni 258, 22328, Bucharest, Romania; Phone: 0040212750558, Fax: 0040213180447; e-mail: preda_monicaa@yahoo.com


DOI 10.12865/CHSJ.42.02.01 - Download PDF
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