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deBruyn JC, Huynh HQ, Griffiths AM, Jacobson K, Mack D, Deslandres C, El-Matary W, Otley AR, Church PC, Lawrence S, Wine E, Sherlock M, Critch J, Benchimol EI, Jantchou P, Rashid M, Carroll MW, Bax K, Ricciuto A, Carman N, Walters TD, Crowley E. ADALIMUMAB VERSUS INFLIXIMAB IN LUMINAL PEDIATRIC CROHN'S DISEASE: COMPARABLE OUTCOMES IN A PROSPECTIVE MULTICENTER COHORT STUDY. Am J Gastroenterol 2023:00000434-990000000-00900. [PMID: 37787642 DOI: 10.14309/ajg.0000000000002552] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 09/22/2023] [Indexed: 10/04/2023]
Abstract
BACKGROUND This study compared real-world effectiveness between adalimumab (ADA) and infliximab (IFX) in children with Crohn's disease (CD). METHODS Children enrolled into the prospective Canadian Children Inflammatory Bowel Disease Network (CIDsCaNN) National Inception Cohort between 2014 and 2020 who commenced ADA or IFX as first anti-tumor necrosis factor (antiTNF) agent for luminal CD were included. Multivariate logistic regression modelled the propensity of commencing ADA; propensity score matching was used to match IFX-treated children to ADA-treated children. The primary outcome at one year was steroid-free clinical remission (SFCR). Secondary outcomes at one year were I) combined SFCR and c-reactive protein (CRP) remission; II) treatment intensification; and III) antiTNF durability. Odds ratios (aOR) and hazard ratio (aHR) adjusted for concomitant immunomodulator use with 95% confidence interval (CI) are reported. RESULTS In the propensity score matched cohort of 147 ADA-treated and 147 IFX-treated children, 92 (63%) ADA- and 87 (59%) IFX-treated children achieved SFCR at one year (aOR: 1.4, 95% CI 0.9-2.4); 75 of 140 (54%) ADA- and 85 of 144 (59%) IFX-treated children achieved combined SFCR and CRP remission (aOR: 1.0, 95% CI 0.6-1.6). ADA-treated children less frequently underwent treatment intensification (21 [14%]) compared to IFX-treated children (69 [47%]) (P<0.0001). Discontinuation of antiTNF occurred in 18 (12%) ADA-treated and 15 (10%) IFX-treated children (aHR: 1.2, 95% CI 0.6-2.2). CONCLUSION Children with Crohn's disease achieved favourable outcomes at one year with either ADA or IFX as first antiTNF agents. Those receiving IFX did not have significantly superior outcomes compared to clinically similar children receiving ADA.
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Affiliation(s)
| | - Hien Q Huynh
- Stollery Children's Hospital, University of Alberta, Edmonton, Canada
| | - Anne M Griffiths
- The Hospital for Sick Children, University of Toronto, Toronto, Canada
- Department of Paediatrics and Institute for Health Policy and Management, University of Toronto
| | - Kevan Jacobson
- British Columbia Children's Hospital, University of British Columbia, Vancouver, Canada
| | - David Mack
- Children's Hospital of Eastern Ontario and University of Ottawa, Ottawa, Canada
| | | | - Wael El-Matary
- Winnipeg Children's Hospital, University of Manitoba, Winnipeg, Canada
| | | | - Peter C Church
- The Hospital for Sick Children, University of Toronto, Toronto, Canada
- Department of Paediatrics and Institute for Health Policy and Management, University of Toronto
| | - Sally Lawrence
- British Columbia Children's Hospital, University of British Columbia, Vancouver, Canada
| | - Eytan Wine
- Stollery Children's Hospital, University of Alberta, Edmonton, Canada
| | - Mary Sherlock
- McMaster Children's Hospital, McMaster University, Hamilton, Canada
| | - Jeffrey Critch
- Janeway Children's Health and Rehabilitation Centre, Memorial University, St. John's, Canada
| | - Eric I Benchimol
- The Hospital for Sick Children, University of Toronto, Toronto, Canada
- Department of Paediatrics and Institute for Health Policy and Management, University of Toronto
| | | | - Mohsin Rashid
- IWK Health Centre, Dalhousie University, Halifax, Canada
| | - Matthew W Carroll
- Stollery Children's Hospital, University of Alberta, Edmonton, Canada
| | - Kevin Bax
- Children's Hospital London Health Sciences Centre, London
| | - Amanda Ricciuto
- The Hospital for Sick Children, University of Toronto, Toronto, Canada
- Department of Paediatrics and Institute for Health Policy and Management, University of Toronto
| | - Nicholas Carman
- The Hospital for Sick Children, University of Toronto, Toronto, Canada
| | - Thomas D Walters
- The Hospital for Sick Children, University of Toronto, Toronto, Canada
- Department of Paediatrics and Institute for Health Policy and Management, University of Toronto
| | - Eileen Crowley
- Children's Hospital London Health Sciences Centre, London
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