Background: Adalimumab (ADA) and infliximab (INF) are approved for treating patients with ulcerative colitis (UC) who have failed conventional therapy. Research comparing the effectiveness of these therapies following induction is limited. We compared the real-world effectiveness of initiating ADA versus INF among patients in the early weeks of treatment.
Methods: 170 randomly selected physicians in the U.S. retrospectively abstracted clinical and healthcare resource utilization information from the charts of adults with UC initiating ADA or INF therapy between 1 Oct 2012 and 30 Apr 2014. Patients were anti-TNF naïve, did not have a Crohn's disease diagnosis and had ≥6 months of follow-up data available. Disease and symptom control were assessed by measuring the probabilities of remission, normal physician global assessment (PGA), normal stool frequency, and absence of rectal bleeding at 8, 12, 16, 20, and 24 weeks after initiating ADA or INF. Probabilities were estimated using Kaplan–Meier curves and compared between treatments using log-rank tests. Patient demographics and the time to first physician- or patient-initiated office visit since starting treatment were compared using Wilcoxon rank sum tests (continuous data) and chi-squared tests (categorical data).
Results: Of 804 eligible patients, 380 initiated ADA and 424 initiated INF. Both groups were similar demographically, except for race/ethnicity. More ADA patients were white (ADA 78.9% vs INF 71.5%, p=0.0144) and fewer were black (ADA 8.7% vs INF 16.3%, p=0.0012). There were no differences between ADA and INF patients with regards to the probabilities of disease and symptom control at any time point between 8 and 24 weeks after initiating therapy (Table 1). The number of patients with a first office visit after starting treatment by each follow-up point was similar between groups (Table 2).
Conclusions: ADA and INF were similarly effective in UC patients in real-world clinical practice as early as 8 weeks after initiating treatment. These data are consistent with those from clinical trials and network meta-analyses.