2019 Volume 45 Issue 12 Pages 674-681
The biologics infliximab (IFX) and adalimumab (ADA) have high therapeutic efficacy for Crohn's disease, and are used to treat many patients. However, randomized controlled trials (RCT) have not been conducted to compare their efficacy in biologic treatment-naive patients. Although RCT are not feasible, we used the propensity score (PS) matching to compare the efficacy of both drugs. We evaluated the short-term efficacy (CRP change three months after the start of treatment) and the long-term efficacy (treatment continuation rate). Among all patients (IFX: 101, ADA: 76), there were significantly more cases of fever in the IFX group and many cases of fistula and abdominal mass. There was no significant difference in CRP variation (P = 0.98). Treatment continuation rates were evaluated by two methods: the cumulative treatment continuation rate (end point: drug withdrawal) and non-event treatment continuation rate (end point: drug withdrawal, dose increase, or enterectomy). There was no significant difference in the cumulative treatment continuation rate between the IFX and ADA groups, but the IFX group had a slightly higher continuation rate (P = 0.054). There was no significant difference in the non-event treatment continuation rate (P = 0.42).
Sixty patients in each group were extracted by PS matching. There were no significant differences in CRP variation (P = 0.69), the cumulative treatment continuation rate (P = 0.15), or the non-event treatment continuation rate (P = 0.32) between the IFX and ADA groups. Our study suggests that there is no difference in efficacy between IFX and ADA.
