Infliximab comparable with ustekinumab for biologic-naïve CD patients

In the treatment of biologic-naïve patients with Crohn’s disease (CD), infliximab is as good as ustekinumab in terms of efficacy and speed of onset, according to a study.

The study was a posthoc analysis of two large CD clinical trial programmes, which involved a total of 420 biologic-naïve CD patients. Efficacy was assessed by proportions of patients achieving clinical remission, clinical response, and normalization of calprotectin at week 6. These endpoints were compared between treatment groups.

Multivariate logistic regression was applied in the analysis to control for confounders. Further, a sensitivity analysis was conducted using propensity scores to create a cohort of matched participants with similar distribution of baseline covariates.

At week 6, the number of patients achieving clinical remission with infliximab did not significantly differ from that with ustekinumab (44.9 percent vs 37.9 percent; adjusted odds ratio [aOR], 1.22, 95 percent confidence interval [CI], 0.79–1.89). The same was true for clinical response rates, which were 58.4 percent with infliximab and 54.9 percent with ustekinumab (aOR, 1.25, 95 percent CI, 0.82–1.90).

There was no significant between-group difference observed for achieving faecal calprotectin <250 mcg/L in those with elevated values at baseline (42.3 percent with infliximab vs 34.7 percent with ustekinumab; aOR, 1.34, 95 percent CI, 0.79–2.28).

A similar pattern of results was seen for all analyses done within the propensity-score matched cohort.