Document Detail


Comparative effectiveness of anti-TNF agents for Crohn's disease in a tertiary referral IBD practice.
MedLine Citation:
PMID:  23014844     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The three Food and Drug Administration (FDA)-approved anti-tumor necrosis factor drugs (anti-TNFs) for Crohn's disease (CD) have not been directly compared.
AIM: To compare the efficacy of the three anti-TNFs for CD in clinical practice.
METHODS: Retrospective review of patients initiated on anti-TNF between 2004 and 2008. Disease activity, quality of life, and remission rates were compared between groups over 1 year.
RESULTS: Sixty patients with CD were initiated on anti-TNF from 2004 to 2008: 31 on infliximab (IFX) and 29 on adalimumab (ADA) or certolizumab pegol (CTZ). More patients in the ADA/CTZ scores group had prior exposure to anti-TNF (76 versus 10%, p < 0.01). Mean Harvey-Bradshaw Index (HBI) scores in the IFX group were lower than in the ADA/CTZ group at 12 months (2.72 ± 3.34 versus 5.63 ± 5.33, p = 0.03). At 12 months, more IFX patients were in remission compared with those on ADA/CTZ (88 versus 53%, p ≤ 0.01). Mean short inflammatory bowel disease questionnaire (SIBDQ) scores were not different between the IFX and ADA/CTZ groups at 12 months. Stratified analyses and logistic regression based on prior anti-TNF use did not show differences in remission rates at any time point post-baseline between groups.
CONCLUSIONS: After adjustment for prior anti-TNF there was no difference in remission rates between the IFX and ADA/CTZ groups at any time point post-baseline. This suggests that differences between groups were accounted for by a higher rate of prior anti-TNF in the ADA/CTZ group. Our results should be reviewed with caution given the small sample size.
Authors:
Seema A Patil; Ankur Rustgi; Patricia Langenberg; Raymond K Cross
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Publication Detail:
Type:  Journal Article     Date:  2012-09-27
Journal Detail:
Title:  Digestive diseases and sciences     Volume:  58     ISSN:  1573-2568     ISO Abbreviation:  Dig. Dis. Sci.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-01-29     Completed Date:  2013-03-28     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  7902782     Medline TA:  Dig Dis Sci     Country:  United States    
Other Details:
Languages:  eng     Pagination:  209-15     Citation Subset:  AIM; IM    
Affiliation:
Division of Gastroenterology and Hepatology, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Anti-Inflammatory Agents / therapeutic use
Antibodies, Monoclonal / therapeutic use*
Antibodies, Monoclonal, Humanized / therapeutic use*
Crohn Disease / drug therapy*,  pathology
Humans
Immunoglobulin Fab Fragments / therapeutic use*
Middle Aged
Polyethylene Glycols / therapeutic use*
Remission Induction
Retrospective Studies
Tumor Necrosis Factor-alpha / antagonists & inhibitors*
Young Adult
Chemical
Reg. No./Substance:
0/Anti-Inflammatory Agents; 0/Antibodies, Monoclonal; 0/Antibodies, Monoclonal, Humanized; 0/Immunoglobulin Fab Fragments; 0/Polyethylene Glycols; 0/Tumor Necrosis Factor-alpha; 0/infliximab; FYS6T7F842/adalimumab; UMD07X179E/certolizumab pegol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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