Remicade, Stelara have similar speed of onset in Crohn’s
Patients with Crohn’s disease who were biologic naive had similar rates of clinical remission and speed of onset whether they were treated with Remicade or Stelara, according to study results.
“Rapidity of symptom relief has become a means by which biologics are differentiated,” Neeraj Narula, MD, from the division of gastroenterology at McMaster University, and colleagues wrote. “TNF alpha antagonists such as [Remicade (infliximab, Janssen)] are often perceived to be the more rapidly acting than biologics with newer mechanisms of action. However, published comparisons for rapidity of symptom relief are generally lacking in CD.”
Researchers analyzed data from two large CD clinical trial programs comprising 420 patients who were biologic naive. They compared proportions of patients achieving clinical remission, clinical response and normalization of calprotectin at week 6.
Narula and colleagues found that a comparable number of patients achieved clinical remission in both the infliximab and Stelara (ustekinumab, Janssen) groups (44.9% vs. 37.9%; adjusted OR = 1.22; 95% CI, 0.79-1.89). The clinical response rates were also not significantly different (58.4% vs. 54.9%; aOR = 1.25; 95% CI, 0.82-1.9).
Additionally, researchers observed no difference in achieving a week 6 fecal calprotectin level of less than 250 µg/L in patients who were evaluated at baseline (42.3% vs. 34.7%; aOR = 1.34; 95% CI, 0.79-2.28).
“Head-to-head trials of biologics in CD are currently ongoing and will augment our knowledge, however, specific prospective trials comparing infliximab versus ustekinumab in biologic naive patients are not currently in progress,” Narula and colleagues wrote. “Therefore, our findings may inform clinical practice when choosing between these therapies.”