MedPath

Comparison Between Infliximab and Adalimumab on Patients With Ulcerative Colitis

Completed
Conditions
Inflammatory Bowel Diseases
Ulcerative Colitis
Interventions
Registration Number
NCT06269185
Lead Sponsor
Vastra Gotaland Region
Brief Summary

Anti-TNF (tumor necrosing factor) treatment with infliximab (IFX) and adalimumab (ADA) are established first-line biological therapies used in treatment of patients with ulcerative colitis (UC). There are no head-to-head comparative studies between these two drug but meta-analysis of randomized controlled trials states that IFX might be more effective than ADA for the induction of clinical remission. However, several observational studies conclude that ADA seem to have similar effect as IFX in treating patients with UC but these studies have limitations.

The overall aim of this retrospective multicenter observational cohort study is to evaluate if there is a difference in efficacy between infliximab (IFX) and adalimumab (ADA) in treating bio-naive patients with UC in the short and long term during the modern era when therapeutic drug monitoring have been used to optimize anti-TNF treatment.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
271
Inclusion Criteria
  • Age 18-100 years.
  • Diagnosis of ulcerative colitis confirmed by endoscopy and histology.
  • Mild, moderate and severe disease activity.
  • Initiation of IFX or ADA-treatment at one of the centers of the study.
Exclusion Criteria
  • Clinical remission.
  • Previous colonic surgery (resection of colonic segment or colectomy).
  • Primary indication for anti-TNF therapy by other disease than UC.
  • Prior use of any anti-TNF or other biologic or small molecule therapy.
  • Rescue therapy (i.e. infliximab used on hospitalized patients receiving intravenous corticosteroids).

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
InfliximabInfliximabBio-naive patients with ulcerative colitis who starts treatment with infliximab
AdalimumabAdalimumabBio-naive patients with ulcerative colitis who starts treatment with adalimumab
Primary Outcome Measures
NameTimeMethod
Percentage of patients achieving steroid-free clinical remissionOne year after start of anti-TNF therapy

Partial Mayo score ≤2 with no subscore \>1 and no use of steroids between 6 and 12 months after start of anti-TNF therapy (Partial Mayoscore, range 0-9, with higher value indicating more severe disease activity).

Secondary Outcome Measures
NameTimeMethod
Percentage of patients achieving biochemical remissionOne year after start of anti-TNF therapy

Fecal Calprotectin \<250 mg/kg

Percentage of patients achieving clinical responseThree months after start of anti-TNF therapy

A decrease in the partial Mayo score from baseline of 2 or more points, along with either a rectal bleeding subscore of 0 or 1 or a decrease in the rectal bleeding subscore of 1 point or more (Partial Mayoscore, range 0-9, with higher value indicating more severe disease activity).

Percentage of patients achieving endoscopic response3-12 months after start of anti-TNF therapy

A decrease in endoscopic Mayo score of 1 or more points (Endoscopic Mayoscore, range 0-3, with higher value indicating more severe disease activity).

Percentage of patients achieving clinical remissionOne year after start of anti-TNF therapy

Partial Mayo score ≤2 with no subscore \>1 (Partial Mayoscore, range 0-9, with higher value indicating more severe disease activity).

Percentage of patients achieving endoscopic remission3-12 months after start of anti-TNF therapy

Endoscopic Mayo score 0-1 (Endoscopic Mayoscore, range 0-3, with higher value indicating more severe disease activity).

Trial Locations

Locations (1)

Västra Götalandsregionen

🇸🇪

Göteborg, Sweden

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