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Remicade Prevents Serious Infection, Longer Hospitalization in UC Patients vs. Humira
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LAS VEGAS — Patients with ulcerative colitis treated with Remicade were more likely to not experience serious infection or longer hospitalization compared with patients treated with Humira, according to a presentation from a plenary session at ACG 2016.
“TNF [alpha] antagonists are a mainstay of management of patients with moderate-severe IBD ... [but] there are no head-to-head trials,” Siddharth Singh, MD, MS, of the University of California San Diego, said during his presentation.
Siddharth Singh
Singh and colleagues identified 78,197 patients with IBD using the National Patient Registry-IBD and Danish Drug Prescription Registry and Ministry of Health. They conducted a propensity-matched cohort study and evaluated 831 patients with UC and Crohn’s disease enrolled in the Danish cohort of IBD patients between 2005 and 2014 who underwent first-time anti-TNF therapy with Remicade (infliximab, Janssen) or Humira (adalimumab, AbbVie). Of the patients with UC, 62.4% were treated with infliximab.
Propensity-score matched analysis showed patients with UC treated with adalimumab had higher risks of all-cause hospitalization (HR = 1.85; 95% CI, 1.16-2.96) and UC-related hospitalization (HR = 2.03; 95% CI, 1.07-3.87) compared with those treated with infliximab. These risks were without significant differences in the risk for abdominal surgery (HR = 1.38) or need for corticosteroids (HR = 0.93), according to the abstract.
In further analysis, patients with Crohn’s disease showed no significant difference in the risk for all-cause hospitalization (HR = 0.8), CD-related hospitalization (HR = 0.84), major abdominal surgery (HR = 0.97), need for corticosteroids (HR = 1.38) or risk for serious infections (HR = 0.39) between patients treated with infliximab vs. those treated with adalimumab.
“In biologic-naive patients with UC, infliximab may be associated with a lower risk of all-cause and UC-related hospitalization and serious infection,” Singh said, noting that effects were more prominent in patients on combination therapy. However, in biologic-naive patients with CD, the two therapies are largely comparable.
Singh concluded: “Infliximab may be a preferred agent in sicker patients with UC, though they are largely comparable in patients with CD. With the advent of new biologic therapies, head-to-head trials are warranted to inform comparative efficacy of agents.” – by Melinda Stevens
Reference:
Singh S, et al. Abstract #10. Presented at: American College of Gastroenterology Annual Scientific Meeting; Oct. 14-19, 2016; Las Vegas, NV.
Disclosure: Singh reports no relevant financial disclosures. One of the researchers reports consulting for AbbVie, Amgen, Bristol-Myers Squibb, Eli Lilly, Janssen, Mesoblast, Seres Therapeutics, Sun Pharma, Takeda and UCB Pharma; and grant/research support from AbbVie, Amgen, Celgene, Genentech, Gilead, Janssen, Pfizer, Receptos, Robarts Clinical Trials, Seres Therapeutics, Takeda and UCB Pharma.
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