title: Effectiveness and safety of infliximab and adalimumab for ambulatory Crohn's disease patients in primary gastroenterology centres.
abstract: BACKGROUND
  Infliximab (IFX) and adalimumab (ADA) are the key treatments for Crohn's Disease (CD), unresponsive to standard treatments. Our aim was to compare the efficacy and safety of IFX and ADA in treating CD in clinical practice.
  
  
  METHODS
  One hundred and twenty-six patients (61 M, 65 F, mean age 36.2 years, range 19-67 years), affected by CD, were treated with infliximab (IFX, 59 patients) or adalimumab (ADA, 66 patients). Clinical efficacy, mucosal healing (MH), histological healing (HH), and safety were assessed. MH was defined complicated if healing of ulcers occurred with deformation of bowel profile and/or complete colonoscopy was impossible because of scars.
  
  
  RESULTS
  Patients were followed-up for 36 months. No difference was found between IFX and ADA in maintaining long-term clinical remission, MH and HH. Complicated MH was present in 17 (28.8%) patients in IFX group and in 7 (10.6%) patients in ADA group (p=0.012). In 9 (15.2%) patients in IFX group and 2 (3.0%) patients in ADA group colonoscopy was incomplete without cecal intubation or terminal ileum exploration (p=0.024). Side effects were similar in both groups.
  
  
  CONCLUSIONS
  Both IFX and ADA seem to be effective and safe in long-term outpatient treatment of CD in clinical practice.
authors.affiliation: Gastroenterology Service, ASL BAT, Andria, BT, Italy. Electronic address: antotursi@tiscali.it.
authors.forename: Antonio
authors.initials: A
authors.lastname: Tursi
authors.affiliation: Division of Gastroenterology, ASL Roma H, Albano Laziale, Rome, Italy.
authors.forename: Walter
authors.initials: W
authors.lastname: Elisei
authors.affiliation: Division of Surgery, "P. Colombo" Hospital, Velletri, Rome, Italy.
authors.forename: Marcello
authors.initials: M
authors.lastname: Picchio
authors.affiliation: Division of Gastroenterology, "San Paolo" Hospital, Bari, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Penna
authors.affiliation: Division of Gastroenterology, "Cristo Re" Hospital, Rome, Italy.
authors.forename: Piera Giuseppina
authors.initials: PG
authors.lastname: Lecca
authors.affiliation: Digestive Endoscopy Unit, "Santa Maria Goretti" Hospital, Latina, Italy.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Forti
authors.affiliation: Digestive Endoscopy and Nutrition Unit, "S. Eugenio" Hospital, Rome, Italy.
authors.forename: GianMarco
authors.initials: G
authors.lastname: Giorgetti
authors.affiliation: Division of Gastroenterology, "Belcolle Hospital", Viterbo, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Faggiani
authors.affiliation: Division of Gastroenterology, "Belcolle Hospital", Viterbo, Italy.
authors.forename: Costantino
authors.initials: C
authors.lastname: Zampaletta
authors.affiliation: Division of Gastroenterology, "Belcolle Hospital", Viterbo, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Pelecca
authors.affiliation: Division of Gastroenterology, "Cristo Re" Hospital, Rome, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Brandimarte
mesh_terms: D000068879:Adalimumab; D000328:Adult; D000368:Aged; D000553:Ambulatory Care; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D003424:Crohn Disease / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D006801:Humans; D000069285:Infliximab; D007413:Intestinal Mucosa / Q000187:drug effects / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012074:Remission Induction; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha; D055815:Young Adult
chemical_list: D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D000068879:Adalimumab
keywords: Anti-TNFα; Clinical practice; Clinical remission; Crohn's disease; Histological healing; Mucosal healing