Durak Muhammed B, Cagir Yavuz, Yuksel Ilhami
Department of Gastroenterology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
Department of Gastroenterology, Ankara City Hospital, Ankara, Turkey.
Saudi J Gastroenterol. 2025 Jan 1;31(1):22-27. doi: 10.4103/sjg.sjg_180_24. Epub 2024 Dec 30.
To compare the long-term safety and efficacy of Adalimumab (ADA) and Infliximab (IFX) agents in biologic-naive patients with Ulcerative colitis (UC).
The key focus was on specific outcomes such as the requirement of hospitalization due to UC, colectomy, steroid administration, and severe infections that led to the discontinuation of therapy.
Anti-TNF treatment was initiated in 208 of the 475 patients with ulcerative colitis. The final study population consisted of 86 biologic-naive patients with UC, including 41 treated with IFX and 45 treated with ADA. No significant differences in treatment details, baseline Mayo scores, risk factors, or demographic features were observed. The ADA group displayed a significantly increased need for steroids (44.4%) compared to the IFX group (14.6%). The UC-associated hospitalization, colectomy, and serious infections were similar between the ADA and IFX groups. Similar outcomes were observed with IFX or ADA as monotherapy or in combination with immunomodulators. The survival analysis revealed IFX had a longer time to secondary loss of response compared to ADA, however, without statistical significance (72.5% versus 46.7%, P = 0.057).
Our results hint at the likelihood of IFX and ADA presenting similar clinical outcomes as first-time agents in UC. Nonetheless, the need for steroids with ADA should be taken into consideration.
比较阿达木单抗(ADA)和英夫利昔单抗(IFX)在初治溃疡性结肠炎(UC)患者中的长期安全性和疗效。
重点关注特定结局,如因UC住院的需求、结肠切除术、类固醇给药以及导致治疗中断的严重感染。
475例溃疡性结肠炎患者中有208例开始抗TNF治疗。最终研究人群包括86例初治UC患者,其中41例接受IFX治疗,45例接受ADA治疗。在治疗细节、基线梅奥评分、危险因素或人口统计学特征方面未观察到显著差异。与IFX组(14.6%)相比,ADA组对类固醇的需求显著增加(44.4%)。ADA组和IFX组在UC相关住院、结肠切除术和严重感染方面相似。IFX或ADA作为单一疗法或与免疫调节剂联合使用时观察到相似的结果。生存分析显示,与ADA相比,IFX至二次反应丧失的时间更长,但无统计学意义(72.5%对46.7%,P = 0.057)。
我们的结果表明,IFX和ADA作为UC的首次治疗药物可能呈现相似的临床结局。尽管如此,应考虑ADA对类固醇的需求。