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Crohn’s patients new to biologics show similar outcomes with Humira vs. Remicade
Humira and Remicade showed comparable safety and effectiveness in patients with Crohn’s disease previously unexposed to biologics, according to the results of a Danish population-based cohort study.
“We observed that adalimumab [Humira, AbbVie], and infliximab [Remicade, Janssen] were comparable in terms of risk of IBD-related hospitalization, major abdominal surgery, new initiation of corticosteroids and serious infections, although adalimumab-treated patients had lower risk of all-cause hospitalization,” Siddharth Singh, MD, MS, of the division of gastroenterology at University of California, San Diego, and colleagues wrote.
Using a national registry, Singh and colleagues identified 2,908 adults with Crohn’s disease treated with adalimumab or infliximab as their first biologic between 2005 and 2014. After propensity-score matching, they compared key safety and effectiveness outcomes between 315 patients treated with adalimumab and 512 treated with infliximab. Both groups showed comparable baseline characteristics, Median disease duration was 4 years, median follow-up after starting biologic therapy was 2.3 years, and 36.9% of patients previously underwent abdominal surgery.
Throughout follow-up, patients treated with adalimumab showed a lower rate of all-cause hospitalization vs. those treated with infliximab (HR = 0.74; 95% CI, 0.56-0.97), but IBD-related hospitalizations (HR = 0.81; 95% CI, 0.55-1.2), major abdominal surgeries (HR = 1.24; 95% CI, 0.66-2.33) and incidence of serious infections requiring hospitalization (HR = 1.06; 95% CI, 0.26-4.21) did not differ significantly.
The investigators saw similar results among patients treated with biologics alone or in combination with immunomodulators.
While they noted that the findings should be interpreted with caution given the limitations in study design, Singh and colleagues concluded that “with the advent of biosimilars, with similar effectiveness of their originator compound, this information may enable informed decision-making in choosing [TNF-alpha] antagonists in biologic-naive patients with [Crohn’s disease.]” – by Adam Leitenberger
Disclosures: Singh reports he has served as a consultant for AbbVie and has received research funding from Pfizer and AbbVie. Please see the full study for a list of all other authors’ relevant financial disclosures.