According to a presentation from the 2016 American College of Gastroenterology (ACG) Annual Scientific Meeting, patients with ulcerative colitis treated with Remicade® (infliximab) were less likely to experience serious infection or longer hospitalization than patients treated with Humira® (adalimumab).
Ulcerative colitis (UC) is an inflammatory bowel disorder (IBD) as is Crohn’s disease. Although both manifest as chronic immune-mediated inflammation of the gastrointestinal system and thus cause similar symptoms, they are managed differently. Also, colitis affects only the colon, or large intestine, whereas Crohn’s can affect any part of the gastrointestinal system. In ulcerative colitis, the lining of the colon becomes inflamed and develops tiny, open sores (ulcers) that produce pus and mucous. The combination of inflammation and ulceration can cause abdominal discomfort, frequent bowel movements, and infection.
Both Remicade and Humira are biologics that help control the development of inflammation by blocking a protein (tumor necrosis factor-alpha) made by the immune system. In short, they are TNF-blockers, and therapy using these drugs is considered as anti-TNF therapy. Neither drug affects a cure for ulcerative colitis or Crohn’s—they are used to manage and reduce symptoms of both diseases and are indicated for other autoimmune conditions.
For this propensity-matched cohort study (statistical), Siddharth Singh, MD, MS, of the University of California San Diego, evaluated 831 patients with UC and Crohn’s enrolled in the Danish cohort of IBD patients who in the years between 2005 and 2014 underwent first-time anti-TNF therapy with Remicade or Humira. Of those with UC, 62.4% were treated with Remicade.
Analysis showed that patients with UC treated with Humira were at higher risk—for not only UC-related hospitalization, but for other unrelated conditions also. The risks had no significant differences between abdominal surgery or for the need of corticosteroids.
However, patients with Crohn’s showed no significant difference between Crohn’s-related and unrelated hospitalization, surgery, need for corticosteroids, or infection between those treated with Humira versus those treated with Remicade.
Although Dr. Sighn concluded that Remicade may be more beneficial for patients with UC, more studies need to be done, especially as advancements in biologics continue. He says, “With the advent of new biologic therapies, head-to-head trials are warranted to inform comparative efficacy of agents.”
Reference: Singh S, et al. Abstract #10. Presented at the American College of Gastroenterology Annual Scientific Meeting; Oct. 14-19, 2016; Las Vegas, NV.
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