Efficacy and safety of biosimilar IFX (CT-P13) and adalimumab in patients with active fistulizing perianal Crohn’s disease naďve to anti-TNF therapy: preliminary results from the POLIBD study

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DOI:

https://doi.org/10.15584/ejcem.2019.1.2

Keywords:

adalimumab, Crohn’s disease, IFX, perianal fistula

Abstract

Introduction. The development of perianal fistulas are a risk factor in colonic and rectal disease. Perianal CD treatment requires a combination of surgical and therapeutic treatments aimed to prevent septic complications, reduce fistula discharge and ultimately heal fistulas.

Aim. The purpose of the study was to evaluate the efficacy and safety of biosimilar IFX (CT-P13) and adalimumab in active fistulizing perianal Crohn’s disease (CD) in patients from the Subcarpathian Region (South-Eastern Poland).

Material and methods. Thirty patients with CD with perianal fistulas naïve to anti-TNF therapy were enrolled (13 females/ 17males) ranging from 18 to 64 years of age. Twenty-one were treated with biosimilar infliximab (CT-P13), nine were treated with adalimumab (ADA). The treated patients had ileal CD (4), ileo-colonic CD (13) or colonic CD (13). All of them received standard immunosuppression with no additional steroid therapy. Response was evaluated at week 16 and 40 after the first CT-P13 dose, and 16 and 40 weeks after the first ADA dose. Remission was defined as the complete closure of all fistulas and partial response as a reduction (≥50%) in the number of draining fistulas.

Results. Treatment outcomes with CT-P13 and ADA were both effective and similar in the percentage of patients with perianal fistula improvement, perianal fistula remission, no effect or observed adverse events.

Conclusion. In patients with active fistulizing CD, both CT-P13 and ADA were effective and safe, however a slight superiority of CT-P13 was visible.

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References

Hellers G, Bergstrand O, Ewerth S, et al. Occurrence and outcome after primary treatment of anal fistulae in Crohn’s disease. Gut. 1980;21:525–7.

Bataille F, Klebl F, Rümmele P, et al. Morphological characterisation of Crohn’s disease fistulae. Gut. 2004;53:1314–1321.

Bernstein LH, Frank MS, Brandt LJ, et al. Healing of perineal Crohn’s disease with metronidazole. Gastroenterology. 1980;79:599.

Bartnik W, Wejman J. Atlas kliniczno-patologiczny nieswoistych chorób Poznań, Poland: Termedia Wydawnictwo Medyczne; 2011:41.

Yarur AJ, Strobel SG, Deshpande AR, Abreu MT. Predictors of Aggressive Inflammatory Bowel Disease. Gastroenterol Hepatol. 2011;7(10):652-659.

Gecse KB, Bemelman W, Kamm MA, et al. A global consensus on the classification, diagnosis and multidisciplinary treatment of perianal fistulising Crohn's disease. Gut. 2014;63(9):1381-92.

Present DH, Rutgeerts P, Targan S, et al. In fliximab for the treatment of fistulas in patients with Crohn’s disease. N Engl J Med. 1999;340:1398–405.

Sands BE, Anderson FH, Bernstein CN, et al. In fliximab maintenance therapy for fistulizing Crohn’s disease. N Engl J Med. 2004;350:876–85.

Colombel JF, Sandborn WJ, Rutgeerts P, et al. Adalimumab for maintenance of clinical response and remission in patients with Crohn’s disease: the CHARM trial. Gastroenterology. 2007;132:52–65.

Echarri A, Castro J, Barreiro M, et al. Evaluation of adalimumab therapy in multidisciplinary strategy for perianal Crohn’s disease patients with infliximab failure. J Crohn’s Colitis. 2010;4:654–60.

Lichtiger S, Binion DG, Wolf DC, et al. The CHOICE trial: adalimumab demonstrates safety, fistula healing, improved quality of life and increased work productivity in patients with Crohn’s disease who failed prior infliximab therapy. Aliment Pharmacol Ther. 2010;32:1228–39.

Koelbel G, Schmiedl U, Majer MC, et al. Diagnosis of fistulae and sinus tracts in patients with Crohn disease: value of MR imaging. AJR Am J Roentgenol. 1989;152:999–1003.

Haggett PJ, Moore NR, Shearman JD, et al. Pelvic and perineal complications of Crohn’s disease: assessment using magnetic resonance imaging. Gut. 1995;36:407–10.

Bell SJ, Halligan S, Windsor AC, et al. Response of fistulating Crohn’s disease to infliximab treatment assessed by magnetic resonance imaging. Aliment Pharmacol Ther. 2003;17:387–93.

Buchanan GN, Owen HA, Torkington J, et al. Long-term outcome following loose-seton technique for external sphincter preservation in complex anal fistula. Br J Surg. 2004;91:476–80.

Pearson DC, May GR, Fick GH, et al. Azathioprine and 6-mercaptopurine in Crohn disease. A meta-analysis. Ann Intern Med. 1995;123:132–42.

Sands BE, Anderson FH, Bernstein CN, et al. In fliximab maintenance therapy for fistulizing Crohn’s disease. N Engl J Med. 2004;350:876–85.

Colombel JF, Sandborn WJ, Reinisch W, et al. In fliximab, azathioprine, or combination therapy for Crohn’s disease. N Engl J Med. 2010;362:1383–95.

Bouguen G, Siproudhis L, Gizard E, et al. Long-term outcome of perianal fistulizing Crohn’s disease treated with infliximab. Clin Gastroenterol Hepatol. 2013;8:975–81.

Doecke JD, Hartnell F, Bampton P, et al. Infliximab vs. adalimumab in Crohn's disease: results from 327 patients in an Australian and New Zealand observational cohort study. Aliment Pharmacol Ther. 2017;45(4):542-552.

Brandt LJ, Bernstein LH, Boley SJ, et al. Metronidazole therapy for perineal Crohn’s disease: a follow-up study. Gastroenterology. 1982;83:383–7.

Jakobovits J, Schuster MM. Metronidazole therapy for Crohn’s disease and associated fistulae. Am J Gastroenterol.1984;79:533–40.

West RL, Woude CJ, Hansen BE, et al. Clinical and endosonographic effect of ciprofloxacin on the treatment of perianal fistulae in Crohn’s disease with infliximab: a double-blind placebo-controlled study. Aliment Pharmacol Ther. 2004:1329–36.

Dewint P, Hansen BE, Verhey E, et al. Adalimumab combined with ciprofloxacin is superior to adalimumab monotherapy in perianal fistula closure in Crohn’s disease: a randomised, double-blind, placebo controlled trial (ADAFI). Gut. 2014;63:292–9.

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Published

2019-03-30

How to Cite

Pękala, A., Aebisher, D., Pardak, P., & Filip, R. (2019). Efficacy and safety of biosimilar IFX (CT-P13) and adalimumab in patients with active fistulizing perianal Crohn’s disease naďve to anti-TNF therapy: preliminary results from the POLIBD study. European Journal of Clinical and Experimental Medicine, 17(1), 12–15. https://doi.org/10.15584/ejcem.2019.1.2

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