Summary Background TNFα antagonists, including infliximab ( IFX) and adalimumab ( ADA), have revolutionised treatment for Crohn's disease. Studies comparing efficacy in patients with Crohn's disease naïve to TNFα antagonists are lacking. Methods
TNFα antagonist‐naïve patients with luminal or perianal Crohn's disease from four tertiary centres in Austria were assessed prospectively for induction and maintenance efficacy, and safety, of either IFXor ADA. Results
In a total of 362 patients, 251 (69.3%) started
IFXand 111 (30.7%) started ADA. At baseline, the median Harvey–Bradshaw Index ( HBI) score was 8 (range 5–29) and 8 (5–36), and the median C‐reactive protein ( CRP) was 1.07 (interquartile range ( IQR) 1.36) mg/dL and 1.16 ( IQR1.23) mg/dL for IFXand ADA, respectively. At week 12, there was no difference between IFXand ADAamong patients with luminal Crohn's disease in clinical remission ( IFX128/204; 62.7% vs. ADA68/107; 63.6%, P= 0.47), clinical response ( IFX154/204; 75.5% vs. ADA82/107; 76.6%, P= 0.82) and steroid‐free remission ( IFX110/204; 53.9% vs. ADA61/107; 57%, P= 0.60). At 12 months, there were similar numbers of patients treated with IFXand ADAwho maintained clinical remission ( IFX77/154; 50.4% vs. ADA47/82; 57.3%, P= 0.48) and steroid‐free remission ( IFX68/154; 44.3% vs. ADA44/82; 53.7%, P= 0.16). Baseline CRP>0.7 mg/dL ( OR0.24; 95% CI0.07–0.77, P= 0.01) was the only predictor of clinical remission at 12 months in patients who did not have escalation of anti‐ TNFα therapy. Conclusion IFXand ADAappear comparable in clinical outcomes for patients with Crohn's disease who are naïve to TNFα antagonists.