Evidence map›Paper›PMID 37540392›Full record

ArticleDigestive diseases and sciences2023

Superior Efficacy of Infliximab Versus Adalimumab for First-Line Treatment of Crohn's Perianal Fistulae.

Laura Maas, Ruiyi Gao, Vivy Cusumano, Ellen Spartz, Reezwana Chowdhury, Mahesh Krishna, Mark Lazarev, Joanna Melia, Florin Selaru, Sowmya Sharma and 2 more

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In one paragraph

Article in Digestive diseases and sciences, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
1.6field-weighted citation impact, top 15% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 5 citations in OpenAlex.

  1. Guideline
  2. Review
  3. Review
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 1 institution in 1 country.

Laura MaasDivision of Gastroenterology & Hepatology, Johns Hopkins University School of Medicine, 4940 Eastern Avenue, Baltimore, MD, 21224, USA. lmaas3@jh.edu.ORCID http://orcid.org/0000-0002-2401-2685
Ruiyi GaoDivision of Gastroenterology & Hepatology, Johns Hopkins University School of Medicine, 4940 Eastern Avenue, Baltimore, MD, 21224, USA.
Vivy CusumanoDivision of Digestive Diseases, Center for Inflammatory Bowel Diseases, Vatche & Tamar Manoukian, UCLA School of Medicine, Los Angeles, CA, USA.
Ellen SpartzDivision of Digestive Diseases, Center for Inflammatory Bowel Diseases, Vatche & Tamar Manoukian, UCLA School of Medicine, Los Angeles, CA, USA.
Reezwana ChowdhuryDivision of Gastroenterology & Hepatology, Johns Hopkins University School of Medicine, 4940 Eastern Avenue, Baltimore, MD, 21224, USA.
Mahesh KrishnaDivision of Gastroenterology & Hepatology, Johns Hopkins University School of Medicine, 4940 Eastern Avenue, Baltimore, MD, 21224, USA.
Mark LazarevDivision of Gastroenterology & Hepatology, Johns Hopkins University School of Medicine, 4940 Eastern Avenue, Baltimore, MD, 21224, USA.
Joanna MeliaDivision of Gastroenterology & Hepatology, Johns Hopkins University School of Medicine, 4940 Eastern Avenue, Baltimore, MD, 21224, USA.
Florin SelaruDivision of Gastroenterology & Hepatology, Johns Hopkins University School of Medicine, 4940 Eastern Avenue, Baltimore, MD, 21224, USA.
Sowmya SharmaDivision of Gastroenterology & Hepatology, Johns Hopkins University School of Medicine, 4940 Eastern Avenue, Baltimore, MD, 21224, USA.
Berkeley LimketkaiDivision of Digestive Diseases, Center for Inflammatory Bowel Diseases, Vatche & Tamar Manoukian, UCLA School of Medicine, Los Angeles, CA, USA.
Alyssa ParianDivision of Gastroenterology & Hepatology, Johns Hopkins University School of Medicine, 4940 Eastern Avenue, Baltimore, MD, 21224, USA.
Johns Hopkins University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCrohn's disease perianal fistulae (CD-PAF) occur in 25% of patients and are notoriously challenging to manage. Tumor necrosis factor inhibitors are first line agents.

aimsThe aim of this study was to compare infliximab (IFX) versus adalimumab (ADA) efficacy in CD-PAF healing over time.

methodsA retrospective study at two large-tertiary medical centers was performed. Inclusion criteria were actively draining CD-PAF and initial treatment with IFX or ADA following CD-PAF diagnosis. The primary endpoints were perianal fistula response and remission at 6 and 12 months. Secondary endpoints included biologic persistence over time and dose escalation at 6 and 12 months.

resultsAmong 151 patients included in the study, 92 received IFX and 59 received ADA as first line agents after CD-PAF diagnosis. At 6 months, the 64.9% of the IFX group and 34.8% of the ADA group demonstrated CD-PAF clinical improvement (p < 0.01). Univariate and multivariate analyses demonstrated significant differences among the IFX and ADA groups for clinical response at 6-months and 12-months (p = 0.002 and p = 0.042, respectively). There were no factors that predicted response, with the exception of concomitant immunomodulator affecting the 6-month clinical response (p = 0.021). Biologic persistence, characterized by Kaplan Meier methods, was significantly longer in the IFX group compared to the ADA group (Log-rank p = 0.01).

conclusionIFX induction and maintenance is associated with higher rates of response and remission in CD-PAF healing as well as higher treatment persistence compared to ADA. Additionally, our study supports the use of concomitant immunomodulator therapy for CD-PAF healing and remission.

Indexed as

Biological ProductsCrohn DiseaseRectal FistulaAdalimumabHumansImmunologic FactorsInfliximabRetrospective StudiesTreatment OutcomeTumor Necrosis Factor-alphaAdalimumabBiological ProductsImmunologic FactorsInfliximabTumor Necrosis Factor-alphaCrohn’s diseaseInflammatory bowel diseasePerianal diseasePerianal fistulaTumor necrosis factor inhibitor

Identifiers

PMID37540392
OpenAlexW4385564241

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.