Studying activity and toxicity of different TNF-alpha inhibitors in controlling patients with active ulcerative colitis

Abstract

Ulcerative colitis (UC) is a long-term disorder that associated with overactivation of immunoinflammatory system, ending with ulcer in the large intestine. This study aimed to compare the activity and toxicity of different TNF-alpha inhibitors in a sample of Iraqi patients having active ulcerative colitis. Fifty patients with refractory ulcerative colitis were randomly distributed to either group I (n = 25): on adalimumab injection (160/80 mg) or group II (n = 25): on infliximab injection (5 mg/kg) along the term of induction. Clinical remission was considered as the primary subjective parameter, while clinical response, mucosal healing, and subscores of mild status were regarded as secondary subjective parameters. Fractional Mayo score, inflammatory bowel disease questionnaire (IBDQ), and safety profile were also evaluated. A 24% versus 28% patients were in clinical remission for those receiving adalimumab and infliximab, respectively (p > 0.05), while 48% versus 52% patients were in clinical response for those receiving adalimumab and infliximab, respectively (p > 0.05), and 40% of patients acquired mucosal healing for both adalimumab and infliximab arms (p > 0.05). Scores of physician assessment and rectal bleeding was shown to be markedly higher in infliximab patients (p < 0.05), while those of stool frequency was found to be higher in adalimumab patients (p < 0.05). No significant difference was observed between two arms in the fractional Mayo score and IBDQ index (p > 0.05). Both of the studied biological agents were well-tolerated. As conclusion, the two different TNF-alpha inhibitors were comparable in their clinical remission and safety profile for subjects with active ulcerative colitis.