Treatment Persistence of Infliximab Versus Adalimumab in Ulcerative Colitis: A 16-Year Single-Center Experience

Background: Infliximab and adalimumab are widely used in the treatment of patients with ulcerative colitis (UC). There are few published data on the treatment persistence of infliximab and adalimumab in patients with UC. Methods: We aimed to compare the treatment persistence rates of infliximab versus adalimumab as first- and second-line tumor necrosis factor antagonists (anti-TNF), to identify factors potentially associated with persistence, and to evaluate reasons for withdrawal in UC patients. We performed a retrospective, single-center cohort study of UC patients treated with infliximab or adalimumab for at least 6 months between June 2002 and May 2018. Results: The median (interquartile range [IQR]) duration of follow-up was 5.4 (3.2-8.3) years. For first-line anti-TNF agent, data on 160 patients with UC were analyzed. The mean (SD) duration of persistence was 3.4 (3.5) years and 2.1 (2.0) years in the infliximab and adalimumab subgroups, respectively (P = 0.24). Concomitant use of 5-aminosalicylate was associated with higher persistence of first-line anti-TNF treatment in the overall population (hazard ratio [HR] 0.5; 95% CI, 0.3-0.8; P = 0.002). For second-line anti-TNF agent, data on 43 patients were analyzed. The mean (SD) duration of persistence was 2.0 (1.7) years and 3.2 (3.1) years in the infliximab and adalimumab subgroups, respectively (P = 0.95). No factors were associated with persistence of second-line anti-TNF treatment. Conclusions Infliximab and adalimumab showed similar levels of persistence as first-and second-line anti-TNF treatments. Concomitant use of 5-aminosalicylates was associated with higher persistence of first-line anti-TNF treatment.