Comparative Effectiveness of Anti-TNF Agents for Crohn’s Disease in a Tertiary Referral IBD Practice

Patil, Seema; Rustgi, Ankur; Langenberg, Patricia; Cross, Raymond K.

doi:10.1007/s10620-012-2323-0

Cited by 22 publications

(25 citation statements)

References 17 publications

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“…Infliximab, adalimumab, and certolizumab are all FDA-approved for CD, and infliximab, adalimumab, and golimumab are all approved for UC. Typical rates of clinical response and remission to these drugs in IBD appear similar in clinical trials and observational studies, in addition to secondary outcomes like hospitalizations and quality of life [3][4][5][6].…”

Section: Currently Available Biologic Agentsmentioning

confidence: 81%

Optimizing Biologic Agents in Ulcerative Colitis and Crohn’s Disease

O’Toole

Moss

2015

Curr Gastroenterol Rep

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The goals of therapy in inflammatory bowel disease (IBD) are the induction and maintenance of clinical and biological remission. Mucosal healing is desirable to prevent complications and reduce the need for surgery, hospitalizations, and steroid exposure. Therapeutic monoclonal antibodies (biologic agents) have revolutionized the treatment of IBD. The initial magnitude of the clinical/biologic response to these agents has been associated with a number of underlying phenotypic features in the recipient. In addition, the durability of the initial response often declines over time. This can occur due to low drug serum drug levels, anti-drug antibodies, and a shift to alternative inflammatory pathways. This review discusses strategies that may optimize the initial response to biologics and sustain this to improve patient outcomes.

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Section: Currently Available Biologic Agentsmentioning

confidence: 81%

Optimizing Biologic Agents in Ulcerative Colitis and Crohn’s Disease

O’Toole

Moss

2015

Curr Gastroenterol Rep

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“…11,12 Retrospective and nonrandomised studies have demonstrated IFX and ADA to have similar clinical outcomes in avoidance of corticosteroids, surgery, hospitalisation and improvement in quality of life in patients with CD. [13][14][15][16][17] In summary, biologic and retrospective clinical data suggest similar therapeutic activity of these agents in CD. Head-to-head direct comparative efficacy trials among anti-TNF agents for CD have not been performed.…”

Section: Introductionmentioning

confidence: 88%

Systematic review with network meta‐analysis: the efficacy of anti‐TNF agents for the treatment of Crohn's disease

Stidham

Lee

Higgins

et al. 2014

Aliment Pharmacol Ther

183

107

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SummaryBackgroundAnti‐tumour necrosis factor‐alpha agents (anti‐TNF) are effective therapies for the treatment of Crohn's disease (CD), but their comparative efficacy is unknown.AimTo perform a network meta‐analysis comparing the efficacy of anti‐TNF therapies in CD.MethodsAfter screening 506 studies, reviewers extracted information on 10 studies. Traditional meta‐analysis (TMA) was used to compare each anti‐TNF agent to placebo. Bayesian network meta‐analysis (NMA) was performed to compare the effects of anti‐TNF agents to placebo. In addition, sample sizes for comparative efficacy trials were calculated.ResultsCompared to placebo, TMA revealed that anti‐TNF agents result in a higher likelihood of induction of remission and response (RR: 1.66, 95% CI: 1.17–2.36 and RR: 1.43, 95% CI: 1.17–1.73, respectively) as well as maintenance of remission and response (RR: 1.78, 95% CI: 1.51–2.09 and RR: 1.68, 95% CI: 1.46–1.93, respectively). NMA found nonsignificant trends between infliximab and adalimumab or certolizumab pegol. Among subcutaneous therapies, NMA demonstrated superiority of adalimumab to certolizumab pegol for induction of remission (RR: 2.93, 95% CrI: 1.21–7.75). Sample size calculations suggest that adequately powered head‐to‐head comparative efficacy trials would require greater than 3000 patients.ConclusionsAll anti‐TNF agents are effective for induction and maintenance of response and remission in the treatment of CD. Although adalimumab is superior to certolizumab pegol for induction of remission, there is no evidence of clinical superiority among anti‐TNF agents. Head‐to‐head trials among the anti‐TNF agents are impractical in terms of size and cost.

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“…In such circumstances, anti-tumor necrosis factor therapy may be an alternative treatment for pyoderma gangrenosum. A previous comparison of the efficacy of infliximab and adalimumab for Crohn's disease in clinical practice showed no difference in the remission rates between the groups at any time point post-baseline (14). Hence, it follows that patients can select a therapeutic option based on its indications, the mode of administration, side effects, and the scientific evidence of its efficacy and safety.…”

Section: Discussionmentioning

confidence: 95%

Successful Use of Adalimumab for Treating Pyoderma Gangrenosum with Ulcerative Colitis under Corticosteroid-tapering Conditions

et al. 2015

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A 52-year-old woman with ulcerative colitis was admitted to our hospital for an ulcerative colitis flare-up under salazosulfapyridine therapy. The symptoms improved with high-dose corticosteroids. After prednisolone was tapered to 10 mg, the frequency of diarrhea increased. The diarrhea was accompanied by joint pain and a skin ulcer with abscess formation, which was diagnosed to be pyoderma gangrenosum. The patient was started on adalimumab. A positive response to the adalimumab therapy was observed after 2 weeks, during which time the ulcerative skin lesion healed completely, however, colonic mucosal healing was achieved at 2 months. Therefore, adalimumab appears to be an effective therapeutic option for patients with ulcerative colitis-associated pyoderma gangrenosum.

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Comparative Effectiveness of Anti-TNF Agents for Crohn’s Disease in a Tertiary Referral IBD Practice

Cited by 22 publications

References 17 publications

Optimizing Biologic Agents in Ulcerative Colitis and Crohn’s Disease

Optimizing Biologic Agents in Ulcerative Colitis and Crohn’s Disease

Systematic review with network meta‐analysis: the efficacy of anti‐TNF agents for the treatment of Crohn's disease

Successful Use of Adalimumab for Treating Pyoderma Gangrenosum with Ulcerative Colitis under Corticosteroid-tapering Conditions

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