Back to Search
Start Over
Comparative effectiveness and safety of infliximab and adalimumab in patients with ulcerative colitis.
- Source :
-
Alimentary pharmacology & therapeutics [Aliment Pharmacol Ther] 2016 May; Vol. 43 (9), pp. 994-1003. Date of Electronic Publication: 2016 Mar 15. - Publication Year :
- 2016
-
Abstract
- Background: Real-world comparative benefits and risks of infliximab (IFX) and adalimumab (ADA) in patients with ulcerative colitis (UC) are unclear.<br />Aim: To evaluate the comparative effectiveness and safety of IFX and ADA in patients with UC who were new users of anti-TNF agents.<br />Methods: Using an administrative claims database (Optum Labs Data Warehouse), we identified patients who received first anti-TNF (IFX, ADA) prescription after a 12-month period without any anti-TNF treatment (baseline), and with a minimum 6-month follow-up after anti-TNF initiation. Primary outcome measures were: all-cause and UC-related hospitalisation, abdominal surgery, corticosteroid use >60 days after starting anti-TNF, and serious infections. We performed 2:1 propensity-score matched Cox proportional hazard analysis, and inverse probability-of-treatment weight (IPTW) analysis, accounting for healthcare utilisation, comorbidities and use of UC-related medication.<br />Results: We included 1400 new users of anti-TNF agents (age, 43 ± 15 years; 52% males), from 2006 to 2014. On propensity-score matched analysis, there was no significant difference in the risk of UC-related hospitalisation [IFX vs. ADA; adjusted hazard ratio (aHR), 1.04; 95% confidence interval (CI) 0.71-1.51], corticosteroid use (aHR, 0.85; 95% CI, 0.68-1.06) and serious infections (aHR, 0.62; 95% CI, 0.29-1.34) between IFX- and ADA-treated patients; the number of surgical events was very small. On IPTW analysis, risk of corticosteroid use was significantly lower in IFX - as compared to ADA - treated patients (aHR, 0.82; 95% CI, 0.68-0.99). Results were stable on multiple sensitivity analyses.<br />Conclusions: In a large retrospective cohort of patients with UC who were new users of anti-TNF agents, IFX-treated patients may have lower corticosteroid use than ADA-treated patients, but risk of hospitalisation and serious infections were comparable.<br /> (© 2016 John Wiley & Sons Ltd.)
- Subjects :
- Adalimumab administration & dosage
Adalimumab adverse effects
Adult
Female
Gastrointestinal Agents administration & dosage
Gastrointestinal Agents adverse effects
Glucocorticoids administration & dosage
Hospitalization
Humans
Infliximab administration & dosage
Infliximab adverse effects
Insurance Claim Review
Male
Middle Aged
Proportional Hazards Models
Retrospective Studies
Adalimumab therapeutic use
Colitis, Ulcerative drug therapy
Gastrointestinal Agents therapeutic use
Infliximab therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 1365-2036
- Volume :
- 43
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- Alimentary pharmacology & therapeutics
- Publication Type :
- Academic Journal
- Accession number :
- 26991059
- Full Text :
- https://doi.org/10.1111/apt.13580