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An indirect comparison of infliximab versus adalimumab or golimumab for active ulcerative colitis

View Article: PubMed Central - PubMed

ABSTRACT

Introduction: The aim of the study was to compare adalimumab or golimumab with infliximab in patients with moderately-to-severely active ulcerative colitis (UC).

Material and methods: This paper was prepared according to the PRISMA guidelines. The systematic literature search was performed in PubMed, Embase, and Cochrane Library. No direct head-to-head comparisons for infliximab vs. adalimumab or golimumab were available so an indirect comparison according to the Bucher method was performed after a homogeneity evaluation of the included studies.

Results: Six RCTs were included in the systematic review. An indirect comparison was performed, which revealed that infliximab was more effective in inducing clinical response compared with both doses of adalimumab (160/80 mg or 80/40 mg; p < 0.05), and, in clinical remission, infliximab was more effective than adalimumab (only for a dosage regime of 80/40 mg; p < 0.05). No statistically significant differences in clinical response and clinical remission were observed between infliximab and golimumab in the induction phase. A significant (p < 0.05) advantage only of infliximab compared with adalimumab at doses of 80/40 mg and 80/160 mg was seen in terms of clinical response in the maintenance phase (up to 52–54 weeks). The indirect comparison revealed that serious adverse events were significantly more frequent among patients treated with a maintenance dose of 100 mg of golimumab compared with those treated with infliximab (p < 0.05).

Conclusions: No significant differences in efficacy in the maintenance phase between infliximab and golimumab or adalimumab were revealed. Infliximab proved to be more effective than adalimumab but of similar efficacy to that of golimumab in the induction phase.

No MeSH data available.


Forest plot of direct estimates for: A – infliximab (5 mg) vs. placebo and adalimumab (160/80 mg) vs. placebo, and indirect comparison between the treatments in the case of clinical response after 6–8 weeks of drug administration; B – infliximab (5 mg) vs. placebo and adalimumab (80/40 mg) vs.placebo, and indirect comparison between the treatments in the case of clinical response after 6–8 weeks of drug administration; C – infliximab (5 mg) vs. placebo and golimumab (200/100 mg) vs. placebo, and indirect comparison between treatments in the case of clinical response after 6–8 weeks of drug administration; D – infliximab (5 mg) vs. placebo and adalimumab (160/80 mg) vs. placebo, and indirect comparison between treatments in the case of clinical response after 52–54 weeks of drug administration; E – infliximab (5 mg) vs. placebo and adalimumab (80/40) and (160/80) mg vs. placebo, and indirect comparison between treatments in the case of clinical response after 52–54 weeks of drug administration; F – infliximab (5 mg) vs. placebo and golimumab (50 mg) vs. placebo, and indirect comparison between treatments in the case of clinical response after 52–54 weeks of drug administration; G – infliximab (5 mg) vs. placebo and golimumab (100 mg) vs. placebo, and indirect comparison between treatments in the case of clinical response after 52–54 weeks of drug administration
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Figure 0003: Forest plot of direct estimates for: A – infliximab (5 mg) vs. placebo and adalimumab (160/80 mg) vs. placebo, and indirect comparison between the treatments in the case of clinical response after 6–8 weeks of drug administration; B – infliximab (5 mg) vs. placebo and adalimumab (80/40 mg) vs.placebo, and indirect comparison between the treatments in the case of clinical response after 6–8 weeks of drug administration; C – infliximab (5 mg) vs. placebo and golimumab (200/100 mg) vs. placebo, and indirect comparison between treatments in the case of clinical response after 6–8 weeks of drug administration; D – infliximab (5 mg) vs. placebo and adalimumab (160/80 mg) vs. placebo, and indirect comparison between treatments in the case of clinical response after 52–54 weeks of drug administration; E – infliximab (5 mg) vs. placebo and adalimumab (80/40) and (160/80) mg vs. placebo, and indirect comparison between treatments in the case of clinical response after 52–54 weeks of drug administration; F – infliximab (5 mg) vs. placebo and golimumab (50 mg) vs. placebo, and indirect comparison between treatments in the case of clinical response after 52–54 weeks of drug administration; G – infliximab (5 mg) vs. placebo and golimumab (100 mg) vs. placebo, and indirect comparison between treatments in the case of clinical response after 52–54 weeks of drug administration

Mentions: The indirect comparison showed no significant difference in clinical response between infliximab [37, 38] or adalimumab [31, 32, 39–41] and infliximab [37, 38] or golimumab [42] during the induction phase (6–8 weeks) (Figure 3; Table IV). Also, an indirect comparison of clinical response in the maintenance phase (up to 52–54 weeks) between infliximab [37, 38] or adalimumab [31, 32, 39–41] and infliximab [37, 38] or golimumab [42] showed no significant differences, except for a significant advantage of infliximab at a dose of 5 mg [37, 38] over adalimumab at doses of 80 mg/40 mg [31, 32] and 80/160 mg [31, 32, 39–41] (Figure 3; Table IV).


An indirect comparison of infliximab versus adalimumab or golimumab for active ulcerative colitis
Forest plot of direct estimates for: A – infliximab (5 mg) vs. placebo and adalimumab (160/80 mg) vs. placebo, and indirect comparison between the treatments in the case of clinical response after 6–8 weeks of drug administration; B – infliximab (5 mg) vs. placebo and adalimumab (80/40 mg) vs.placebo, and indirect comparison between the treatments in the case of clinical response after 6–8 weeks of drug administration; C – infliximab (5 mg) vs. placebo and golimumab (200/100 mg) vs. placebo, and indirect comparison between treatments in the case of clinical response after 6–8 weeks of drug administration; D – infliximab (5 mg) vs. placebo and adalimumab (160/80 mg) vs. placebo, and indirect comparison between treatments in the case of clinical response after 52–54 weeks of drug administration; E – infliximab (5 mg) vs. placebo and adalimumab (80/40) and (160/80) mg vs. placebo, and indirect comparison between treatments in the case of clinical response after 52–54 weeks of drug administration; F – infliximab (5 mg) vs. placebo and golimumab (50 mg) vs. placebo, and indirect comparison between treatments in the case of clinical response after 52–54 weeks of drug administration; G – infliximab (5 mg) vs. placebo and golimumab (100 mg) vs. placebo, and indirect comparison between treatments in the case of clinical response after 52–54 weeks of drug administration
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Related In: Results  -  Collection

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Figure 0003: Forest plot of direct estimates for: A – infliximab (5 mg) vs. placebo and adalimumab (160/80 mg) vs. placebo, and indirect comparison between the treatments in the case of clinical response after 6–8 weeks of drug administration; B – infliximab (5 mg) vs. placebo and adalimumab (80/40 mg) vs.placebo, and indirect comparison between the treatments in the case of clinical response after 6–8 weeks of drug administration; C – infliximab (5 mg) vs. placebo and golimumab (200/100 mg) vs. placebo, and indirect comparison between treatments in the case of clinical response after 6–8 weeks of drug administration; D – infliximab (5 mg) vs. placebo and adalimumab (160/80 mg) vs. placebo, and indirect comparison between treatments in the case of clinical response after 52–54 weeks of drug administration; E – infliximab (5 mg) vs. placebo and adalimumab (80/40) and (160/80) mg vs. placebo, and indirect comparison between treatments in the case of clinical response after 52–54 weeks of drug administration; F – infliximab (5 mg) vs. placebo and golimumab (50 mg) vs. placebo, and indirect comparison between treatments in the case of clinical response after 52–54 weeks of drug administration; G – infliximab (5 mg) vs. placebo and golimumab (100 mg) vs. placebo, and indirect comparison between treatments in the case of clinical response after 52–54 weeks of drug administration
Mentions: The indirect comparison showed no significant difference in clinical response between infliximab [37, 38] or adalimumab [31, 32, 39–41] and infliximab [37, 38] or golimumab [42] during the induction phase (6–8 weeks) (Figure 3; Table IV). Also, an indirect comparison of clinical response in the maintenance phase (up to 52–54 weeks) between infliximab [37, 38] or adalimumab [31, 32, 39–41] and infliximab [37, 38] or golimumab [42] showed no significant differences, except for a significant advantage of infliximab at a dose of 5 mg [37, 38] over adalimumab at doses of 80 mg/40 mg [31, 32] and 80/160 mg [31, 32, 39–41] (Figure 3; Table IV).

View Article: PubMed Central - PubMed

ABSTRACT

Introduction: The aim of the study was to compare adalimumab or golimumab with infliximab in patients with moderately-to-severely active ulcerative colitis (UC).

Material and methods: This paper was prepared according to the PRISMA guidelines. The systematic literature search was performed in PubMed, Embase, and Cochrane Library. No direct head-to-head comparisons for infliximab vs. adalimumab or golimumab were available so an indirect comparison according to the Bucher method was performed after a homogeneity evaluation of the included studies.

Results: Six RCTs were included in the systematic review. An indirect comparison was performed, which revealed that infliximab was more effective in inducing clinical response compared with both doses of adalimumab (160/80 mg or 80/40 mg; p < 0.05), and, in clinical remission, infliximab was more effective than adalimumab (only for a dosage regime of 80/40 mg; p < 0.05). No statistically significant differences in clinical response and clinical remission were observed between infliximab and golimumab in the induction phase. A significant (p < 0.05) advantage only of infliximab compared with adalimumab at doses of 80/40 mg and 80/160 mg was seen in terms of clinical response in the maintenance phase (up to 52–54 weeks). The indirect comparison revealed that serious adverse events were significantly more frequent among patients treated with a maintenance dose of 100 mg of golimumab compared with those treated with infliximab (p < 0.05).

Conclusions: No significant differences in efficacy in the maintenance phase between infliximab and golimumab or adalimumab were revealed. Infliximab proved to be more effective than adalimumab but of similar efficacy to that of golimumab in the induction phase.

No MeSH data available.