Treatment Persistence of Infliximab Versus Adalimumab in Ulcerative Colitis: A 16-Year Single-Center Experience

Pouillon, Lieven; Baumann, Cédric; Rousseau, Hélène; Choukour, Myriam; Andrianjafy, Charlotte; Danese, Silvio; Peyrin–Biroulet, Laurent

doi:10.1093/ibd/izy322

Cited by 25 publications

(38 citation statements)

References 31 publications

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“…As the analysis focused on persistence during maintenance in patients who had completed the induction phase of biologic therapy without switching or discontinuing treatment, differences in the duration of induction between the two biologics were not considered to be relevant. [27][28][29][30][31][32][33] The risk of hospitalization would not be expected to increase in the combination subgroups given that there were no significant differences in treatment persistence among the three subgroups. 25,26 Our results indicate that in UC, step-up from a single-agent IM to biologic/IM combination treatment (in the Bio + prior IM subgroup) may be better maintained over the long term than biologic monotherapy if infliximab is chosen.…”

Section: Discussionmentioning

confidence: 99%

“…These findings are consistent with previous data. [27][28][29][30][31][32][33] The risk of hospitalization would not be expected to increase in the combination subgroups given that there were no significant differences in treatment persistence among the three subgroups. A previous US claims analysis has shown an increase in hospitalizations for UC patients without therapeutic persistence to infliximab.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Impact of immunomodulator use on treatment persistence in patients with ulcerative colitis: A claims database analysis

Udagawa

Uda

Hibi

et al. 2019

J of Gastro and Hepatol

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Background and Aim It is unclear how adding an anti‐tumor necrosis factor alpha agent to immunomodulator (IM) treatment, as a step‐up strategy, affects long‐term outcomes in ulcerative colitis. This retrospective study investigated persistence associated with biologic anti‐tumor necrosis factor alpha agents combined with IMs versus biologic monotherapy in patients with ulcerative colitis. Methods This was a longitudinal cohort study of patients in the Japan Medical Data Center claims database who had been newly prescribed infliximab or adalimumab as induction (completed) and maintenance (2010–2016). Biologic persistence (i.e. no switch/discontinuation during maintenance) was compared among patients prescribed biologic monotherapy (Bio) and those prescribed a biologic combined with an IM, as step‐up (Bio + prior IM) or simultaneously (Bio + IM). Results Three hundred and sixty‐nine eligible patients were analyzed (233, 78, and 58 in the Bio, Bio + prior IM, and Bio + IM subgroups, respectively). Multivariate analysis showed a lower probability of nonpersistence during maintenance for infliximab‐treated patients in the Bio + prior IM versus Bio subgroup (hazard ratio: 0.53; 95% confidence interval: 0.29–0.99; P = 0.045). No such effect was seen in adalimumab‐treated patients (P = 0.222) or in the overall population (P = 0.398). The probability of nonpersistence during maintenance in the Bio + IM subgroup was not significantly different from that in the Bio subgroup in either the biologic subpopulation or in the overall population. Conclusions Adding infliximab to an existing IM results in a lower probability of nonpersistence compared with infliximab monotherapy in ulcerative colitis patients. This effect is not seen in adalimumab‐treated patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Impact of immunomodulator use on treatment persistence in patients with ulcerative colitis: A claims database analysis

Udagawa

Uda

Hibi

et al. 2019

J of Gastro and Hepatol

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“…[8][9][10][11] There are also several studies based on health claims data and retrospective studies to compare the efficacy of both infliximab and adalimumab in UC patients. [12][13][14][15][16] However, interpretation of the results is limited because the studies did not correlate the selection criteria and comparison methods.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Long-Term Outcomes of Infliximab versus Adalimumab Treatment in Biologic-Naïve Patients with Ulcerative Colitis

Lee

Park

et al. 2021

Gut and Liver

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Background/Aims The tumor necrosis factor-α inhibitors infliximab and adalimumab are standard treatments for moderate to severe ulcerative colitis (UC). However, there has been no head-to-head comparison of treatment efficacy and outcomes between the two agents. The aim of this study was to compare the efficacy and long-term outcomes of infliximab versus adalimumab treatment in biologic-naïve patients with UC. Methods We retrospectively analyzed the records of 113 biologic-naïve patients with UC who were treated between September 2012 and December 2017 (the infliximab group [n=83] and the adalimumab group [n=30]). We compared remission and response rates between these groups at 8 and 52 weeks. We used Kaplan-Meier curves to compare long-term outcomes, and logistic regression analysis and Cox-proportional hazard regression models to assess factors affecting outcomes. Results The median follow-up duration was 25.8 months. Baseline clinical characteristics were similar between groups. There were no significant differences between the two groups in the rate of clinical remission or clinical response at 8 or 52 weeks. Multivariate analyses also showed that long-term outcomes were not significantly different (adjusted hazard ratio [HR], 1.45; 95% confidence interval [CI], 0.81 to 2.56; p=0.208). An elevated C-reactive protein level (greater than 5 mg/L) was a significant predictive factor for poor outcomes (adjusted HR, 2.25; 95% CI, 1.37 to 3.70; p=0.001). During the follow-up period, the rates of adverse event were not significantly different between the two groups (p=0.441). Conclusions In our study, infliximab and adalimumab had similar treatment efficacy and long-term outcomes in biologic-naïve patients with moderate to severe UC.

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“…In a recent retrospective, single-center cohort study of patients with UC treated with infliximab as a first-line therapy the mean duration of drug persistence was 3.4 (SD 3.5) years, compared with 2.0 (SD 1.7) years when infliximab was used as a second-line treatment. 25 …”

Section: Infliximab and Ucmentioning

confidence: 99%

“… 4 – 29 However, up to 30% of patients show no clinical benefit after induction phase [primary nonresponse (PNR)] and up to 50% have to discontinue therapy, either for secondary loss of response (SLR) or a serious adverse event (SAE), such as infusion reaction, infection and malignancy. 4 – 29 Both PNR and SLR can be largely explained by low or undetectable concentrations due to increased nonimmune clearance and/or immunogenicity, defined as the development of antibodies to infliximab. 30 , 31 Many association studies have demonstrated a relation between infliximab trough concentrations and objective therapeutic outcomes in IBD, especially during maintenance treatment ( Table 2 ).…”

Section: Introductionmentioning

confidence: 99%

Infliximab in inflammatory bowel disease

Papamichael

Lin

Moore

et al. 2019

Therapeutic Advances in Chronic Disease

103

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Anti-tumor necrosis factor (TNF) therapy has revolutionized the medical treatment of the inflammatory bowel diseases (IBD), Crohn’s disease (CD), and ulcerative colitis. Twenty years ago, infliximab became the first anti-TNF agent approved for IBD. Data from randomized controlled trials, large observational cohort studies, postmarketing registries, and meta-analyses show that infliximab is a very effective treatment for moderate to severe IBD with a good safety profile. Infliximab has been also used to treat pouchitis following an ileal pouch–anal anastomosis (IPAA) after restorative proctocolectomy and to prevent postoperative recurrence following an ileocolonic resection for CD with good results. Nevertheless, up to 30% of patients show no clinical benefit following induction and up to 50% lose response over time. Both these unwanted outcomes can be largely explained by inadequate drug concentrations and frequently by the development of antibodies to infliximab. Loss of response can be managed efficiently and often prevented by applying therapeutic drug monitoring. Recently, the first biosimilars of infliximab have been approved and are utilized in clinical practice with comparable efficacy and safety with the originator. This review will mainly focus on the efficacy of infliximab in IBD.

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Treatment Persistence of Infliximab Versus Adalimumab in Ulcerative Colitis: A 16-Year Single-Center Experience

Cited by 25 publications

References 31 publications

Impact of immunomodulator use on treatment persistence in patients with ulcerative colitis: A claims database analysis

Impact of immunomodulator use on treatment persistence in patients with ulcerative colitis: A claims database analysis

Comparison of Long-Term Outcomes of Infliximab versus Adalimumab Treatment in Biologic-Naïve Patients with Ulcerative Colitis

Infliximab in inflammatory bowel disease

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