There are conflicting data on comparative effectiveness of adalimumab and infliximab in patients with Crohn's disease.
Dr Singh and colleagues from California, USA compared the effectiveness and safety of adalimumab and infliximab in biologic-naïve patients with Crohn's disease, in a nationwide register-based propensity score-matched cohort study in Denmark.
A total of 2908 Danish adults with Crohn's disease had been treated with adalimumab or infliximab as their first biologic agent between 2005-2014.
The researchers compared rates of all-cause hospitalisation, Crohn's disease-related hospitalisation, major abdominal surgery and serious infections after variable 2:1 propensity score matching, accounting for baseline disease characteristics, healthcare utilisation and use of Crohn's disease-related medications.
After propensity-score matching, the team included 315 adalimumab- and 512 infliximab-treated patients, with median disease duration of 4 years
The team reported that 37% had prior abdominal surgery.
There were no differences in rate of Crohn's disease-related
hospitaization 2 years after starting biological therapy
Alimentary Pharmacology and Therapeutics
The research team found that over a median follow-up 2.3 years after starting biological therapy, there were no significant differences in rate of Crohn's disease-related hospitalization or major abdominal surgery between adalimumab- and infliximab-treated patients, though rate of all-cause hospitalisation was lower in adalimumab-treated patients.
There was no significant difference in incidence of serious infections requiring hospitalisation.
These results were stable in patients treated with biological monotherapy or in combination with immunomodulators.
Dr Singh's team concludes, "In this population-based, propensity score matched, real-life cohort study using administrative claims, there was no significant difference in effectiveness and safety of adalimumab and infliximab in biologic-naïve patients with Crohn's disease."