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

Abstract Background: To compare the long-term safety and efficacy of Adalimumab (ADA) and Infliximab (IFX) agents in biologic-naive patients with Ulcerative colitis (UC). Methods: The key focus was on specific outcomes such as the requirement of hospitalization due to UC, colectomy, steroid administration, and severe infections that led to the discontinuation of therapy. Results: Anti-TNF treatment was initiated in 208 of the 475 patients with ulcerative colitis. The final study population consisted of 86 biologic-naive patients with UC, including 41 treated with IFX and 45 treated with ADA. No significant differences in treatment details, baseline Mayo scores, risk factors, or demographic features were observed. The ADA group displayed a significantly increased need for steroids (44.4%) compared to the IFX group (14.6%). The UC-associated hospitalization, colectomy, and serious infections were similar between the ADA and IFX groups. Similar outcomes were observed with IFX or ADA as monotherapy or in combination with immunomodulators. The survival analysis revealed IFX had a longer time to secondary loss of response compared to ADA, however, without statistical significance (72.5% versus 46.7%, P = 0.057). Conclusion: Our results hint at the likelihood of IFX and ADA presenting similar clinical outcomes as first-time agents in UC. Nonetheless, the need for steroids with ADA should be taken into consideration.