Comparison of long-term outcomes of infliximab and adalimumab in biologic-naive patients with ulcerative colitis

Abstract Background Data comparing their long-term efficacy and safety of Infliximab (IFX) and adalimumab (ADA) in moderate to severe ulcerative colitis (UC) is limited. In this study we aimed to compare the long-term effectiveness and safety of IFX and ADA in UC who had not previously received biologic therapy. Methods: Data from patients treated between 2007 and 2021 was collected and analyzed. Outcomes evaluated included UC-related hospitalization, colectomy, steroid use, and serious infections leading to treatment cessation. Results Of 86 UC patients, 41 received IFX and 45 received ADA. No differences were found in terms of demographics, risk factors, baseline Mayo scores and treatment history. During anti-TNF therapy, steroid use was significantly higher in the ADA group (44.4%) compared to the IFX group (14.6%). UC-related hospitalization and colectomy rates were similar between the two groups, as were rates of serious infection leading to treatment cessation. These outcomes were similar in UC patients treated with IFX or ADA monotherapy or in combination with an immunomodulator. The Kaplan-Meier analysis showed that the duration of discontinuation of the drug due to secondary loss of response was longer in the IFX group compared ADA the other group, although the difference was not statistically significant (72.5% versus 46.7%, p = 0.057). Conclusion Overall, the study suggests that IFX and ADA may be similar in terms of clinical outcomes for UC patients who are new users of anti-TNF agents, but the higher rate of steroid use in the ADA group should be noted.