• Is infliximab or adalimumab preferred and which is better?

    Tumour necrosis factor (TNF) is an important protein involved in causing inflammation in patients with Crohn’s disease. Antibodies are other proteins which recognise and help to destroy harmful substances as part of the normal working of the human body. Adalimumab and infliximab are artificial antibodies manufactured by drug companies which recognise and help destroy TNF. Both infliximab and adalimumab have both been used to maintain remission in patients with Crohn’s disease. Infliximab has to be given in hospital but adalimumab can be given at home. For this reason some patients get switched from infliximab to adalimumab to reduce the time spent in hospital.

    In this study adults with Crohn’s either continued maintenance infliximab or were switched to adalimumab. Patients were studied for one year to find out how many preferred adalimumab and also how many needed extra treatment or had to stop their existing treatment due to side effects.

    The study was stopped early because of safety concerns within the patients being switched to adalimumab. More patients in the adalimumab group had loss of response or intolerance than those continuing infliximab. However those patients that received adalimumab preferred their treatment.

    Overall this study found that in patients whose remission is maintained by infliximab, switching to adalimumab is worse than continuing infliximab even though patients preferred adalimumab. Adalimumab is often used as a second-line treatment in patients who have stopped responding to infliximab, which is a somewhat different and entirely accepted clinical situation supported by previously published evidence.

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    TW