Bau Mariella, Zacharias Patricia, Ribeiro Diogo Araújo, Boaron Larissa, Steckert Filho Alvaro, Kotze Paulo Gustavo
Unidade de Cirurgia Colorretal, Hospital Universitário Cajuru, Universidade Católica do Paraná, Curitiba, PR, Brasil.
Cirurgia Colorretal, Gastro Medical Center, Florianópolis, SC, Brasil.
Arq Gastroenterol. 2017 Dec;54(4):328-332. doi: 10.1590/S0004-2803.201700000-43. Epub 2017 Sep 21.
Infliximab and adalimumab are considered effective drugs in the management of Crohn's disease. However, due to significant immunossupression, they can cause important adverse events, mostly infections.
The aim of this study was to quantify and describe adverse events derived from adalimumab and infliximab use in Crohn's disease patients, and to compare the safety profile between these two agents.
This was an observational, single-center, longitudinal, retrospective study with Crohn's disease patients under infliximab or adalimumab therapy. Variables analyzed: demographic characteristics (including the Montreal classification), type of agent used, concomitant immunomodulators, presence and types of adverse events observed. Patients were allocated in two groups (infliximab and adalimumab) and had their adverse events accessed and subsequently compared.
A total of 130 patients were included (68 in infliximab and 62 in adalimumab groups, respectively). The groups were fully homogeneous in all baseline characteristics, with a median follow-up of 47.21±36.52 months in the infliximab group and 47.79±35.09 in the adalimumab group (P=0.512). Adverse events were found in 43/68 (63.2%) and 40/62 (64.5%) in each group, respectively (P=0.879). There were no differences between the groups regarding infections (P=0.094) or treatment interruption (P=0.091). There were higher rates of infusion reactions in the infliximab group (P=0.016). Cephalea and injection site reactions were more prevalent in adalimumab patients.
Adverse events were found in approximately two thirds of Crohn's disease patients under anti-TNF therapy, and there were no significant differences between infliximab or adalimumab.
英夫利昔单抗和阿达木单抗被认为是治疗克罗恩病的有效药物。然而,由于显著的免疫抑制作用,它们可导致重要的不良事件,主要是感染。
本研究旨在量化和描述克罗恩病患者使用阿达木单抗和英夫利昔单抗所产生的不良事件,并比较这两种药物的安全性。
这是一项针对接受英夫利昔单抗或阿达木单抗治疗的克罗恩病患者的观察性、单中心、纵向、回顾性研究。分析的变量包括:人口统计学特征(包括蒙特利尔分类)、所用药物类型、同时使用的免疫调节剂、观察到的不良事件的存在情况及类型。患者被分为两组(英夫利昔单抗组和阿达木单抗组),对其不良事件进行评估并随后进行比较。
共纳入130例患者(英夫利昔单抗组68例,阿达木单抗组62例)。两组在所有基线特征上完全同质,英夫利昔单抗组的中位随访时间为47.21±36.52个月,阿达木单抗组为47.79±35.09个月(P = 0.512)。每组分别有43/68(63.2%)和40/62(64.5%)出现不良事件(P = 0.879)。两组在感染方面(P = 0.094)或治疗中断方面(P = 0.091)无差异。英夫利昔单抗组的输注反应发生率较高(P = 0.016)。头痛和注射部位反应在阿达木单抗患者中更为普遍。
接受抗TNF治疗的克罗恩病患者中约三分之二出现不良事件,英夫利昔单抗和阿达木单抗之间无显著差异。