title: A retrospective comparison of infliximab versus adalimumab as induction and maintenance therapy for Crohn disease.
abstract: BACKGROUND
  In Australia, infliximab (IFX) and adalimumab (ADA) are available for the treatment of moderate-severe Crohn disease (CD) refractory to conventional therapies, with minimal local data comparing their efficacy.
  
  
  OBJECTIVE
  The aim of this study was to compare clinical and biochemical outcomes at 3 and 12 months between patients receiving induction and maintenance therapy with IFX versus ADA.
  
  
  METHODS
  Retrospective single-centre audit of all patients commenced on IFX or ADA as their first anti-tumour necrosis factor agent between July 2007 and May 2012. Clinical and biochemical parameters were compared pre-commencement, 3 and 12 months post-commencement.
  
  
  RESULTS
  A total of 81 patients was included in the study; 63 IFX-treated and 18 ADA-treated. Significant Crohn disease activity index (CDAI) reductions were noted within both groups at 3 months (P < 0.001) and 12 months (P < 0.001). Similarly, significant reductions were noted in steroid doses within groups at 3 months (P < 0.05) and 12 months (P < 0.05), with notable reductions in C-reactive protein (CRP) at 3 months within groups (P < 0.05). Adverse events occurred in 14.3% of IFX and 11.1% of ADA patients. Comparing IFX with ADA, no difference was shown between groups in CDAI reductions at 3 months (P = 0.94) and 12 months (P = 0.95), steroid dosing at 3 months (P = 0.23) and 12 months (P = 0.81), and CRP reduction at 3 months (P = 0.33) and 12 months (P = 0.62). Fistula-related admissions were significantly reduced in IFX patients (100% reduction post-IFX vs 66.7% post-ADA) (P = 0.01).
  
  
  CONCLUSIONS
  Clinical and biochemical outcomes were similar in patients treated with IFX or ADA as induction and maintenance therapy for CD. However, significant reductions were noted in admissions relating to fistulising disease in IFX patients.
authors: Department of Gastroenterology, Monash Health, Melbourne, Victoria, Australia.
authors: P
authors: P
authors: Varma
authors: Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.|Clinical Haematology Department, Alfred Health, Melbourne, Victoria, Australia.
authors: E
authors: E
authors: Paul
authors: Department of Medicine, Austin Health, Melbourne, Victoria, Australia.
authors: C
authors: C
authors: Huang
authors: Department of Gastroenterology, Alfred Health, Melbourne, Victoria, Australia.
authors: B
authors: B
authors: Headon
authors: Department of Gastroenterology, Alfred Health, Melbourne, Victoria, Australia.
authors: M P
authors: MP
authors: Sparrow
mesh_terms: D000068879:Adalimumab / Q000008:administration & dosage*; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D001315:Australia; D002097:C-Reactive Protein / Q000032:analysis; D003424:Crohn Disease / Q000188:drug therapy*; D005260:Female; D006801:Humans; D000069285:Infliximab / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D012074:Remission Induction; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors; D055815:Young Adult
chemical_list: D000893:Anti-Inflammatory Agents; D061067:Antibodies, Monoclonal, Humanized; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein; D000069285:Infliximab; D000068879:Adalimumab
keywords: Crohn disease; adalimumab; anti-tumour necrosis factor; inflammatory bowel disease; infliximab