Infliximab edges ahead in severe colitis, but cheaper drug matches long-term results
A real-world study of nearly 400 ulcerative colitis patients shows infliximab works faster and better for severe cases, but adalimumab achieves identical remission rates over time. The finding could reshape treatment guidelines and reimbursement decisions, as adalimumab's lower cost and easier administration make it an increasingly attractive first-line option for milder disease.
Originaltitel: Adalimumab and infliximab are equally efficient in achieving sustained remission in ulcerative colitis but infliximab is superior in severe disease—a retrospective observational study
BACKGROUND AND AIMS: Infliximab and adalimumab are first-line biological therapies in ulcerative colitis. Meta-analyses of randomized control trials indicate infliximab being more effective but observational studies indicate similar effect. Our aim was to compare short- and long-term efficacy of infliximab and adalimumab in bio-naive patients with ulcerative colitis in a real-world setting during the modern era of therapeutic drug monitoring and dose optimization. METHODS: We performed a retrospective multicentre observational cohort study. Patients initiating infliximab or adalimumab at four out-patient IBD-clinics between 2018 and 2022 were included. RESULTS: < 0.05). CONCLUSIONS: Adalimumab and infliximab achieved similar rates of long-term remission in bio-naive patients with ulcerative colitis. However, infliximab was superior in induction of remission and in patients with severe disease.