Bruce Sands (New York City, NY, USA) presented data from the SEAVUE trial—the first head-to-head comparison of biological agents in patients with Crohn's disease. In this randomised trial, biological-naive patients with moderate-to-severe Crohn's disease were randomly assigned to receive either the interleukin-12/23 antagonist ustekinumab (n=191) or the TNFα antagonist adalimumab (n=195) for induction and maintenance therapy. At week 52, 124 (65%) patients in the ustekinumab group and 119 (61%) patients in the adalimumab group were in clinical remission (defined as a Crohn's disease activity index [CDAI] score of less than 150), which was the study's primary endpoint (p=0·417). There were also no significant differences between groups in the key secondary outcomes of corticosteroid-free clinical remission at week 52, clinical response at week 52, patient-reported symptom remission at week 52, clinical remission at week 16, and endoscopic remission at week 52. Infections were more common with adalimumab than with ustekinumab (79 [41%] patients vs 65 [34%] patients), although the number of serious infections was much the same between the two groups (five vs four). Infusion-related adverse events and injection site reactions were more common with adalimumab than with ustekinumab. 22 (11%) of patients in the adalimumab group had an adverse event that led to discontinuation of the study drug, as did 12 (6%) of those in the ustekinumab group.

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DOI: https://doi.org/10.1016/S2468-1253(21)00230-2

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