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Foley E, Basirat A, Yadav A, O'Brien S, Mitchell PD, Donnelly SC. A case of pulmonary and cutaneous sarcoidosis. Breathe (Sheff) 2025; 21:240228. [PMID: 40255295 PMCID: PMC12004252 DOI: 10.1183/20734735.0228-2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2024] [Accepted: 01/08/2025] [Indexed: 04/22/2025] Open
Abstract
A case demonstrating refractory cutaneous and pulmonary sarcoidosis, with classic clinical, spirometry and radiological features, despite OCS and low-dose HCQ treatment that responded clinically and functionally to the addition of a TNF inhibitor https://bit.ly/4h8Gix1.
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Affiliation(s)
- Eimear Foley
- Respiratory Department, Tallaght University Hospital, Dublin, Ireland
| | - Ahmad Basirat
- Respiratory Department, Tallaght University Hospital, Dublin, Ireland
| | - Ankit Yadav
- Respiratory Department, Tallaght University Hospital, Dublin, Ireland
| | - Shane O'Brien
- Respiratory Department, Tallaght University Hospital, Dublin, Ireland
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Patrick D. Mitchell
- Respiratory Department, Tallaght University Hospital, Dublin, Ireland
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Seamas C. Donnelly
- Respiratory Department, Tallaght University Hospital, Dublin, Ireland
- School of Medicine, Trinity College Dublin, Dublin, Ireland
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Alwisi N, Ismail R, Al-Kuwari H, Al-Ansari KH, Al-Matwi MA, Aweer NA, Al-Marri WN, Al-Kubaisi Y, Al-Mohannadi M, Hamran S, Doi SAR, Farooqui HH, Chivese T. Comparative Efficacy of Subcutaneous Versus Intravenous Interleukin 12/23 Inhibitors for the Remission of Moderate to Severe Crohn's Disease: A Systematic Review and Meta-Analysis. Biomedicines 2025; 13:702. [PMID: 40149677 PMCID: PMC11940749 DOI: 10.3390/biomedicines13030702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2024] [Revised: 11/23/2024] [Accepted: 11/26/2024] [Indexed: 03/29/2025] Open
Abstract
Background/Objectives: Interleukin 12/23 inhibitors are a newer class of monoclonal antibodies used to induce and maintain remission for Crohn's disease (CD), a chronic inflammatory bowel disease, when patients do not respond to conventional immunomodulatory drugs or first-line monoclonal antibody therapies. Although biologics are best administered intravenously, subcutaneous administration has been trialed, with mixed results. This research synthesized evidence on the efficacy and safety of subcutaneous compared to intravenous administration of interleukin 12/23 inhibitors for moderate to severe CD. Methods: In this systematic review and meta-analysis, we searched Cochrane, PubMed, SCOPUS, CINHAL, and preprint archives for randomized controlled trials (RCTs) that compared the efficacy and safety of subcutaneous to intravenous interleukin 12/23 inhibitors for the remission of CD. After study quality assessment, a meta-analysis was carried out using a bias-adjusted inverse variance heterogeneity model, heterogeneity was assessed using I2, and publication bias was performed using Doi plots. Evidence certainty was assessed using Grading of Recommendations, Assessment, Development, and Evaluations (GRADE). Results: Seven RCTs, with 2179 participants, all with moderate to severe CD, were included. After meta-analysis, subcutaneous compared to intravenous administration showed similar efficacy for the induction of remission (OR 0.77, 95%CI 0.53-1.12), with no-to-low heterogeneity (I2 = 0%, p = 0.97). For the maintenance of remission, only two studies had analyzable data, and they showed that subcutaneous interleukin 12/23 inhibitors were equal or better compared to intravenous administration. Further syntheses showed that subcutaneous compared to intravenous administration of interleukin 12/23 inhibitors had almost similar odds of adverse events (OR 0.91, 95%CI 0.63-1.32, I2 = 39%), serious adverse events (OR 0.97, 95%CI 0.61-1.53, I2 = 0%), and treatment discontinuation (OR 1.06, 95%CI 0.67-1.68, I2 = 0%). Conclusions: In individuals with moderate to severe CD, subcutaneous administration has similar efficacy for inducing remission with comparable safety. More RCTs are needed to confirm these findings.
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Affiliation(s)
- Nouran Alwisi
- College of Medicine, QU Health, Qatar University, Doha P.O. Box 2713, Qatar; (N.A.); (R.I.); (H.A.-K.); (K.H.A.-A.); (M.A.A.-M.); (N.A.A.); (W.N.A.-M.); (Y.A.-K.); (S.H.); (S.A.R.D.)
| | - Rana Ismail
- College of Medicine, QU Health, Qatar University, Doha P.O. Box 2713, Qatar; (N.A.); (R.I.); (H.A.-K.); (K.H.A.-A.); (M.A.A.-M.); (N.A.A.); (W.N.A.-M.); (Y.A.-K.); (S.H.); (S.A.R.D.)
| | - Hissa Al-Kuwari
- College of Medicine, QU Health, Qatar University, Doha P.O. Box 2713, Qatar; (N.A.); (R.I.); (H.A.-K.); (K.H.A.-A.); (M.A.A.-M.); (N.A.A.); (W.N.A.-M.); (Y.A.-K.); (S.H.); (S.A.R.D.)
| | - Khalifa H. Al-Ansari
- College of Medicine, QU Health, Qatar University, Doha P.O. Box 2713, Qatar; (N.A.); (R.I.); (H.A.-K.); (K.H.A.-A.); (M.A.A.-M.); (N.A.A.); (W.N.A.-M.); (Y.A.-K.); (S.H.); (S.A.R.D.)
| | - Mohammed A. Al-Matwi
- College of Medicine, QU Health, Qatar University, Doha P.O. Box 2713, Qatar; (N.A.); (R.I.); (H.A.-K.); (K.H.A.-A.); (M.A.A.-M.); (N.A.A.); (W.N.A.-M.); (Y.A.-K.); (S.H.); (S.A.R.D.)
| | - Noor A. Aweer
- College of Medicine, QU Health, Qatar University, Doha P.O. Box 2713, Qatar; (N.A.); (R.I.); (H.A.-K.); (K.H.A.-A.); (M.A.A.-M.); (N.A.A.); (W.N.A.-M.); (Y.A.-K.); (S.H.); (S.A.R.D.)
| | - Wejdan N. Al-Marri
- College of Medicine, QU Health, Qatar University, Doha P.O. Box 2713, Qatar; (N.A.); (R.I.); (H.A.-K.); (K.H.A.-A.); (M.A.A.-M.); (N.A.A.); (W.N.A.-M.); (Y.A.-K.); (S.H.); (S.A.R.D.)
| | - Yousif Al-Kubaisi
- College of Medicine, QU Health, Qatar University, Doha P.O. Box 2713, Qatar; (N.A.); (R.I.); (H.A.-K.); (K.H.A.-A.); (M.A.A.-M.); (N.A.A.); (W.N.A.-M.); (Y.A.-K.); (S.H.); (S.A.R.D.)
| | - Muneera Al-Mohannadi
- Department of Gastroenterology and Hepatology, Hamad Medical Corporation, Doha P.O. Box 3050, Qatar;
| | - Shahd Hamran
- College of Medicine, QU Health, Qatar University, Doha P.O. Box 2713, Qatar; (N.A.); (R.I.); (H.A.-K.); (K.H.A.-A.); (M.A.A.-M.); (N.A.A.); (W.N.A.-M.); (Y.A.-K.); (S.H.); (S.A.R.D.)
| | - Suhail A. R. Doi
- College of Medicine, QU Health, Qatar University, Doha P.O. Box 2713, Qatar; (N.A.); (R.I.); (H.A.-K.); (K.H.A.-A.); (M.A.A.-M.); (N.A.A.); (W.N.A.-M.); (Y.A.-K.); (S.H.); (S.A.R.D.)
| | - Habib H. Farooqui
- College of Medicine, QU Health, Qatar University, Doha P.O. Box 2713, Qatar; (N.A.); (R.I.); (H.A.-K.); (K.H.A.-A.); (M.A.A.-M.); (N.A.A.); (W.N.A.-M.); (Y.A.-K.); (S.H.); (S.A.R.D.)
| | - Tawanda Chivese
- College of Medicine, QU Health, Qatar University, Doha P.O. Box 2713, Qatar; (N.A.); (R.I.); (H.A.-K.); (K.H.A.-A.); (M.A.A.-M.); (N.A.A.); (W.N.A.-M.); (Y.A.-K.); (S.H.); (S.A.R.D.)
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Dominati A, Ascoli C, Rubinstein I, McCauley MD, Sweiss NJ. Narrative review of adalimumab for the treatment of cardiac sarcoidosis. Heart Rhythm O2 2025; 6:368-382. [PMID: 40201681 PMCID: PMC11973695 DOI: 10.1016/j.hroo.2024.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2025] Open
Abstract
Cardiac sarcoidosis (CS) remains the second leading cause of death in patients with sarcoidosis, primarily because of its association with heart failure and arrhythmias. While corticosteroids are first-line therapy, their long-term use in CS is associated with serious adverse events, necessitating alternative immunosuppressive therapies, such as tumor necrosis factor inhibitors. Although infliximab is the most studied tumor necrosis factor inhibitor for refractory CS, adalimumab has emerged as a potential alternative. To that end, we reviewed the literature on adalimumab treatment in CS, identifying 12 publications published between January 2000 and September 2024 encompassing 240 patients, of whom 100 (42%) received adalimumab and were followed for at least 6 months. Most patients demonstrated stable or improved left ventricular ejection fraction, even those with initially low left ventricular ejection fraction and reduced cardiac 18F-fluorodeoxyglucose uptake on positron emission tomography-computed tomography. Adalimumab was generally well-tolerated with few reported infections or adverse events. However, these findings are limited by significant heterogeneity in study design, variability in patient populations, and a lack of standardized outcome measures, which restrict their generalizability. While adalimumab shows promise as a therapeutic option for refractory CS, robust, multicenter, randomized controlled trials are needed to validate these findings and define adalimumab's role in clinical practice.
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Affiliation(s)
- Arnaud Dominati
- Division of Rheumatology, Department of Medicine, University of Illinois College of Medicine in Chicago, Chicago, Illinois
- Division of Clinical Immunology and Allergology, Department of Medicine, Geneva University Hospital, Geneva, Switzerland
| | - Christian Ascoli
- Division of Pulmonary, Critical Care, Sleep, and Allergy, Department of Medicine, University of Illinois College of Medicine in Chicago, Chicago, Illinois
| | - Israel Rubinstein
- Division of Pulmonary, Critical Care, Sleep, and Allergy, Department of Medicine, University of Illinois College of Medicine in Chicago, Chicago, Illinois
- Medical and Research Services, Jesse Brown VA Medical Center, Chicago, Illinois
| | - Mark D. McCauley
- Medical and Research Services, Jesse Brown VA Medical Center, Chicago, Illinois
- Division of Cardiology, Department of Medicine, University of Illinois College of Medicine in Chicago, Chicago, Illinois
| | - Nadera J. Sweiss
- Division of Rheumatology, Department of Medicine, University of Illinois College of Medicine in Chicago, Chicago, Illinois
- University of Jordan School of Medicine, Amman, Jordan
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Codesido J, García-Varela L, García-Otero X, Bouzón-Barreiro S, Gómez-Lado N, Toja-Camba FJ, Mondelo-García C, Lazaré H, Torres JB, Vidal-Otero J, Medin-Aguerre S, Sanchez-Crespo A, Otero-Espinar FJ, Herance JR, Fernández-Ferreiro A, Aguiar P. PET biodistribution study of subcutaneous and intravenous administration of adalimumab in an inflammatory bowel disease model. Int J Pharm 2025; 669:125011. [PMID: 39617190 DOI: 10.1016/j.ijpharm.2024.125011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2024] [Revised: 11/22/2024] [Accepted: 11/26/2024] [Indexed: 12/15/2024]
Abstract
Monoclonal antibodies targeting tumor necrosis factor-alpha (antiTNF-α) are used for patients with immuno-mediated illness as inflammatory bowel disease (IBD). However, 20-40 % of IBD patients do not respond to these therapies, and increasing knowledge of biodistribution could optimize their use and consequently their effectiveness. The aim of this study is to compare the biodistribution of adalimumab after intravenous (IV) and subcutaneous (SC) administration using Positron Emission Tomography (PET) imaging in IBD animal models. IBD was induced in mice using oral dextran sulfate sodium (DSS) and each induced animal was individually confirmed using [18F]FDG PET/CT scans, weight monitoring and histopathological analysis of colon tissue samples. The SC and IV biodistribution pharmacokinetics profiles and in vivo biodistribution of adalimumab labeled with 89Zr were evaluated using a dedicated PET/CT scanner. Mean standardized uptake values (SUV) were estimated from the colon, liver, and blood over seven days. Blood analysis revealed faster elimination of adalimumab in IBD models compared to controls, and after IV compared to SC administration (SUV 168 h p.i. SC-IBD = 0.06 ± 0.02, SC-Control = 1.08 ± 0.11, IV-IBD = 0.02 ± 0.01, IV-Control = 0.26 ± 0.13). Furthermore, IBD models exhibited faster whole-body clearance than controls and an earlier and higher concentration peak of adalimumab in the colon after IV (SUV 6 h p.i. IBD-IV = 2.11 ± 0.18) compared to SC administration (SUV 24 h p.i. IBD-SC = 1.49 ± 0.27). Our findings demonstrate the significant influence of the administration route and the TNF-α expression (local and also systemic) on the amount of adalimumab reaching the colon over time.
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Affiliation(s)
- Jessica Codesido
- Molecular Imaging and Pharmacokinetic Modelling Group, CIMUS, University of Santiago de Compostela, Santiago de Compostela, Spain; FarmaCHUSLab Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Lara García-Varela
- Molecular Imaging and Pharmacokinetic Modelling Group, CIMUS, University of Santiago de Compostela, Santiago de Compostela, Spain; Nuclear Medicine and Molecular Imaging Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Xurxo García-Otero
- Molecular Imaging and Pharmacokinetic Modelling Group, CIMUS, University of Santiago de Compostela, Santiago de Compostela, Spain; Nuclear Medicine and Molecular Imaging Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain; Pharmacology, Pharmacy and Pharmaceutical Technology Department, Faculty of Pharmacy, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Sheila Bouzón-Barreiro
- Molecular Imaging and Pharmacokinetic Modelling Group, CIMUS, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Noemí Gómez-Lado
- Molecular Imaging and Pharmacokinetic Modelling Group, CIMUS, University of Santiago de Compostela, Santiago de Compostela, Spain; Nuclear Medicine and Molecular Imaging Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Francisco José Toja-Camba
- FarmaCHUSLab Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain; Pharmacy Department, University Clinical Hospital, Santiago de Compostela (SERGAS), Spain
| | - Cristina Mondelo-García
- FarmaCHUSLab Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain; Pharmacy Department, University Clinical Hospital, Santiago de Compostela (SERGAS), Spain
| | - Héctor Lazaré
- Department of Pathology, University Clinical Hospital, Santiago de Compostela, Spain
| | - Julia Baguña Torres
- Medical Molecular Imaging Research Group and Nuclear Medicine Department, Vall d'Hebron University Hospital, Vall d'Hebron Research Institute (VHIR), Autonomous University Barcelona, CIBER-BBN, Barcelona, Spain
| | - Jana Vidal-Otero
- Pharmacy Department, Vall d'Hebron University Hospital, E-08035 Barcelona, Spain
| | - Santiago Medin-Aguerre
- Galician PET Radiopharmacy Unit, GALARIA, University Clinical Hospital, Santiago de Compostela 15706, Spain
| | - Alejandro Sanchez-Crespo
- Department of Medical Radiation Physics and Nuclear Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Francisco J Otero-Espinar
- Pharmacology, Pharmacy and Pharmaceutical Technology Department, Faculty of Pharmacy, University of Santiago de Compostela, Santiago de Compostela, Spain; Institute of Materials (iMATUS), University of Santiago de Compostela, Santiago de Compostela, Spain; Paraquasil group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - José R Herance
- Medical Molecular Imaging Research Group and Nuclear Medicine Department, Vall d'Hebron University Hospital, Vall d'Hebron Research Institute (VHIR), Autonomous University Barcelona, CIBER-BBN, Barcelona, Spain
| | - Anxo Fernández-Ferreiro
- FarmaCHUSLab Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain; Pharmacy Department, University Clinical Hospital, Santiago de Compostela (SERGAS), Spain
| | - Pablo Aguiar
- Molecular Imaging and Pharmacokinetic Modelling Group, CIMUS, University of Santiago de Compostela, Santiago de Compostela, Spain; Nuclear Medicine and Molecular Imaging Group, University Clinical Hospital, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
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Kamal ME, Werida RH, Radwan MA, Askar SR, Omran GA, El-Mohamdy MA, Hagag RS. Efficacy and safety of infliximab and adalimumab in inflammatory bowel disease patients. Inflammopharmacology 2024; 32:3259-3269. [PMID: 38985232 PMCID: PMC11416362 DOI: 10.1007/s10787-024-01508-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Accepted: 06/06/2024] [Indexed: 07/11/2024]
Abstract
INTRODUCTION Inflammatory bowel disease (IBD), consists of two primary types: Ulcerative Colitis (UC) and Crohn's Disease (CD). Infliximab (IFX) and Adalimumab (ADA) are frequently utilized in the management of moderate to severe cases of IBD. AIM This study aimed to assess the efficacy and safety of IFX and ADA in individuals diagnosed with moderate to severe IBD. METHOD This study is a prospective open-labeled randomized parallel study that included moderate to severe IBD patients treated with either IFX or ADA. A total of 56 patients participated, with 34 patients received IFX and 22 patients received ADA. Various measures, including Crohn's Disease Activity Index (CDAI), Mayo Score/ Disease Activity Index (DAI), and C-reactive protein (CRP) levels, were taken at baseline and week 14 to assess the efficacy of the treatments. In addition, the levels of drugs and sTREM-1 were measured at 14 weeks. Patient safety was monitored throughout the study period. RESULTS In the group received IFX, there was a notable decrease in CDAI (P = 0.045), DAI (P = 0.026), and CRP (P = 0.023 for CD, and P = 0.021 for UC) levels. In addition, the group received ADA experienced a significant reduction in CDAI (P = 0.001), DAI (P = 0.032), and CRP (P < 0.018 for CD and P = 0.003 for UC) levels. Responders had higher drug concentrations than non-responders, notably IFX concentration was higher in responders with CD (P = 0.001) and UC (P < 0.001). ADA concentration was higher in UC (P <= 0.001) and all CD patients responded to the treatment. The same trend was observed for sTREM-1 levels in CD and UC patients (P = 0.042, and P = 0.015, respectively) in the IFX group. In UC patients treated with ADA, the level of sTREM-1 was significantly low (P = 0.002). CONCLUSION Both IFX and ADA have a good safety profile and deliver a beneficial clinical and laboratory response in moderate-severe IBD patients. CLINICAL TRIAL REGISTRATION This study is registered on ClinicalTrials.gov under the identifier NCT05291039. (You can access the study at https://clinicaltrials.gov/study/NCT05291039 (First Posted: March 22, 2022).
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Affiliation(s)
- Mahmoud E Kamal
- Clinical Pharmacy and Pharmacy Practice Department, Faculty of Pharmacy, Egyptian Russian University, Cairo, Egypt.
| | - Rehab H Werida
- Clinical Pharmacy and Pharmacy Practice Department, Faculty of Pharmacy, Damanhour University, Damanhour, Egypt
| | - Mahasen A Radwan
- Clinical Pharmacy and Pharmacy Practice Department, Faculty of Pharmacy, Egyptian Russian University, Cairo, Egypt
| | - Safaa R Askar
- Tropical Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Gamal A Omran
- Biochemistry Department, Faculty of Pharmacy, Damanhour University, Damanhour, Egypt
| | - Marwa A El-Mohamdy
- Clinical Pathology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Radwa S Hagag
- Clinical Pharmacy and Pharmacy Practice Department, Faculty of Pharmacy, Egyptian Russian University, Cairo, Egypt
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Salman A, Salman MA, Elewa A, Awwad AM. Efficacy and Safety of Infliximab Versus Adalimumab in Adult Subjects With Moderate to Severe Ulcerative Colitis: A Systematic Review and Meta-Analysis. Cureus 2024; 16:e61547. [PMID: 38835557 PMCID: PMC11148671 DOI: 10.7759/cureus.61547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2024] [Indexed: 06/06/2024] Open
Abstract
Ulcerative colitis (UC) is an inflammatory disorder affecting the colon, and typically, during the disease course, the condition may exacerbate, relapse, and remit. One of the most successful lines for inducing and maintaining clinical remission in subjects with UC is biological therapy with anti-tumor necrosis factor α (anti-TNF) agents, including adalimumab (ADA) and infliximab (IFX). This meta-analysis is an attempt to obtain complementary information driven by real-world experience (RWE) concerning the efficacy and safety of two of the most popular anti-TNFs in treating UC. This is a systematic review and meta-analysis of RWE studies comparing ADA and IFX as naïve anti-TNF agents for the treatment of subjects with UC. Studies were obtained by searching Scopus, Google Scholar, the Cochrane Central Register of Controlled Trials, Embase, and the PubMed Central databases. Patients treated with IFX showed significantly higher induction responses. No statistically significant difference was found in the comparison of response in the maintenance treatment period. Higher overall adverse events were related to IFX treatment, with serious adverse events that were nonsignificantly higher in the ADA-treated group. In conclusion, IFX demonstrated significantly higher induction responses compared to ADA in patients with moderate-to-severe UC. IFX was associated with higher overall adverse events, whereas serious adverse events were non-significantly higher in the ADA-treated group. IFX may be favored as a first-line agent for its induction efficacy, and the choice between IFX and ADA should be individualized based on comprehensive clinical evaluation.
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Affiliation(s)
- Ahmed Salman
- Department of Internal Medicine, Faculty of Medicine, Cairo University, Cairo, EGY
| | - Mohamed A Salman
- Department of Surgery, KasrAlAiny School of Medicine, Cairo, EGY
| | - Ahmed Elewa
- Department of General, Laparoscopic, and Hepato-Pancreato-Biliary (HPB) Surgery, National Hepatology and Tropical Medicine Research Institute, Cairo, EGY
| | - Asmaa M Awwad
- Department of Radiation Oncology, National Cancer Institute, Cairo University, Cairo, EGY
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Biologics for Inflammatory Bowel Disease in Clinical Practice: A Calabria (Southern Italy) Prospective Pharmacovigilance Study. Pharmaceutics 2022; 14:pharmaceutics14112449. [PMID: 36432640 PMCID: PMC9696291 DOI: 10.3390/pharmaceutics14112449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/05/2022] [Accepted: 11/11/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The use of immune-modifying biological agents has markedly changed the clinical course and the management of Inflammatory bowel diseases (IBDs). Active post-marketing surveillance programs are fundamental to early recognize expected and unexpected adverse events (AEs), representing a powerful tool to better determine the safety profiles of biologics in a real-world setting. METHODS This study aimed to identify the occurrence of AEs and therapeutic failures linked to biological drugs used in gastroenterology units during a prospective pharmacovigilance program in Southern Italy. Patients affected by IBDs and treated with a biologic agent, from 1 January 2019, to 31 December 2021 (study period) in three gastroenterology units were enrolled. RESULTS Overall, 358 patients with a diagnosis of active Crohn's disease or ulcerative colitis satisfying inclusion criteria have been enrolled. Infliximab (IFX) was the most administered drug at the index date (214; 59.8%), followed by Adalimumab (ADA; 89; 24.9%), Golimumab (GOL; 37; 10.3%), Vedolizumab (VDZ; 17; 4.7%) and Ustekimumab (UST; 1; 0.3%). Seventy-three patients (20.4%) experienced at least one AE, while 62 patients (17.3%) had therapeutic ineffectiveness. No serious AEs were reported in the follow-up period in the enrolled patients. AEs have been described with IFX (50/214; p = 0.47), GOL (7/37; p = 0.78), ADA (13/89; p = 0.18), and VDZ (3/17; p = 0.52), no AEs have been noticed with UST (0/1). CONCLUSIONS Based on the low rate of AEs observed and withdrawal from treatment, our data seem to corroborate the favorable beneficial/risk profile of biologics for IBDs.
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