Adalimumab + Methotrexate Beneficial for Pediatric Crohn Disease

THURSDAY, April 27, 2023 (HealthDay News) -- For pediatric Crohn disease (PCD) patients, treatment with methotrexate combined with adalimumab, but not infliximab, is associated with a reduction in treatment failure, according to a study published online March 31 in Gastroenterology.

Michael D. Kappelman, M.D., M.P.H., from the University of North Carolina at Chapel Hill, and colleagues conducted a randomized trial involving PCD patients initiating infliximab or adalimumab who were randomly assigned to methotrexate (156 patients [110 infliximab initiators and 46 adalimumab initiators]) or placebo (141 patients [102 infliximab initiators and 39 adalimumab initiators]).

The researchers found that the time to treatment failure did not differ by study arm in the overall population. No differences were seen between the groups among infliximab initiators, while combination therapy was associated with longer time to treatment failure among adalimumab initiators. There was a trend toward lower antidrug antibodies development observed in the combination therapy arm, which was not significant. No differences were seen in patient-reported outcomes of pain interference and fatigue. More adverse events, but fewer serious adverse events, were seen in the combination therapy arm.

"Our study findings suggest strong consideration of using combination therapy for PCD patients initiating adalimumab but not infliximab," the authors write. "Dissemination and implementation of these findings should lead to improved outcomes in this patient population, including consideration of deimplementation of combination therapy in infliximab-treated patients."

Several authors disclosed financial ties to biopharmaceutical companies, including AbbVie, the manufacturer of adalimumab.

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