Effectiveness and safety of infliximab and adalimumab for ambulatory Crohn's disease patients in primary gastroenterology centres

• Both Infliximab and Adalimumab are effective in ambulatory Crohn’s disease.
• Both Infliximab and Adalimumab are safe in those patients, with low side effects.
• Both Infliximab and Adalimumab maintain mucosal healing in those patients.
• Histological healing in those patients is very low.

BackgroundInfliximab (IFX) and adalimumab (ADA) are the key treatments for Crohn's Disease (CD), unresponsive to standard treatments. Our aim was to compare the efficacy and safety of IFX and ADA in treating CD in clinical practice.MethodsOne hundred and twenty-six patients (61 M, 65 F, mean age 36.2 years, range 19–67 years), affected by CD, were treated with infliximab (IFX, 59 patients) or adalimumab (ADA, 66 patients). Clinical efficacy, mucosal healing (MH), histological healing (HH), and safety were assessed. MH was defined complicated if healing of ulcers occurred with deformation of bowel profile and/or complete colonoscopy was impossible because of scars.ResultsPatients were followed-up for 36 months. No difference was found between IFX and ADA in maintaining long-term clinical remission, MH and HH. Complicated MH was present in 17 (28.8%) patients in IFX group and in 7 (10.6%) patients in ADA group (p = 0.012). In 9 (15.2%) patients in IFX group and 2 (3.0%) patients in ADA group colonoscopy was incomplete without cecal intubation or terminal ileum exploration (p = 0.024).Side effects were similar in both groups.ConclusionsBoth IFX and ADA seem to be effective and safe in long-term outpatient treatment of CD in clinical practice.