Remicade, Humira similarly effective for treatment of IBD
The efficacy of Humira or Remicade was found to be “broadly comparable” in routine clinical treatment of patients with inflammatory bowel disease, according to a recent study.
Because data on the comparative effectiveness of Humira (adalimumab, AbbVie) and Remicade (infliximab, Janssen) are limited, Ashwin N. Ananthakrishnan, MD, MPH, of Harvard Medical School and Massachusetts General Hospital, and colleagues, used a large multi-institutional electronic health record database to compare rates of nonresponse, surgeries and hospitalizations among IBD patients treated with either drug.
Ashwin N. Ananthakrishnan
Patients in the Greater Boston metropolitan area included in the study had either Crohn’s disease or ulcerative colitis and began a prescription for either infliximab or adalimumab between December 4, 1998 and June 10, 2010. In the final cohort, 1,060 patients initiated infliximab (68% for CD), and 391 initiated adalimumab (79% for CD).
“The strengths of our study include the large sample size and use of a validated measure of nonresponse using narrative text in addition to endpoints of IBD-related surgery or hospitalization that allowed for a more comprehensive assessment of comparative effectiveness than either outcome alone or persistence of therapy,” the researchers wrote. This previously validated “likelihood of nonresponse score” accurately distinguished nonresponders from responders, and correlated with need for surgery and hospitalization (P < .0001 for both).
Among patients with CD, a higher symptomatic nonresponse was observed at 1 year with adalimumab compared with infliximab (OR = 1.62; 95% CI, 1.21-2.17), but the difference was moderate, and there was no difference observed in the rate of surgeries, hospitalizations, prednisone use or normalization of C-reactive protein.
Moreover, no differences in outcomes were found between the two medications in patients with ulcerative colitis.
“There is a need for robust studies of comparative effectiveness of available therapies in real-world clinical practice,” the researchers wrote. “As well, it is important for future studies to examine differences in long-term maintenance beyond 1 year to accurately inform decision making of both patients and providers.” – by Suzanne Reist
Disclosures: Ananthakrishnan and Churchill report they received funding from Amgen; Ananthakrishnan has received research support from Cubist and has served on the scientific advisory boards for Cubist, AbbVie, and Exact Sciences.