Comparative Efficacy and Speed of Onset of Action of Infliximab vs Golimumab in Ulcerative Colitis

Siddharth Singh*, James A. Proudfoot, Parambir S. Dulai, Ronghui Xu, Brian G. Feagan, William J. Sandborn, Vipul Jairath

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

Background & Aims: With several options available for patients with moderate–severe ulcerative colitis (UC), rapidity of symptom resolution could be an important differentiator. We compared the efficacy and speed of onset of action of infliximab vs golimumab induction therapy using patient-level data from phase 3 trials (ACT-1, ACT-2, and PURSUIT-SC). Methods: We compared differences in proportions of patients who achieved the composite outcome of a rectal bleeding score=0 and stool frequency score ≤1 (patient-reported outcome 2 remission) at weeks 2 and 6 of treatment with standard-dose infliximab vs golimumab using logistic generalized estimating equation. Overall efficacy for inducing clinical remission (Mayo clinic score <3) was compared using logistic regression. Analyses were adjusted for sex, disease extent, baseline clinical and endoscopic severity, C-reactive protein, albumin, body weight and concomitant medications (immunomosuppressives, corticosteroids, and 5-aminsalicylates). Results: Trial populations were similar and no differences were observed among the placebo groups in the studies. A significantly higher proportion patients treated with infliximab than golimumab achieved patient-reported outcome 2 remission at week 2 (35% vs 30%; adjusted odds ratio [OR], 1.71; 95% CI, 1.15–2.55) and at week 6 (50.0% vs 38.9%; adjusted OR, 2.0; 95% CI, 1.40–2.94). Infliximab-treated patients were also significantly more likely to achieve clinical remission than golimumab-treated patients (adjusted OR, 3.01; 95% CI, 1.95–4.70), with consistent findings in patients with moderate or severe UC. Conclusions: Based on a patient-level analysis of data from phase 3 trials, infliximab resolves symptoms more rapidly and has greater efficacy for inducing remission than golimumab in patients with moderate-to-severe UC.

Original languageEnglish (US)
Pages (from-to)424-431.e7
JournalClinical Gastroenterology and Hepatology
Volume18
Issue number2
DOIs
StatePublished - Feb 2020
Externally publishedYes

Keywords

  • Comparative Efficacy
  • Inflammatory Bowel Diseases
  • Open Science
  • Patient-Reported Outcomes

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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