Omar Arman, MD, MPH1, Laith M.. Haj-Ahmad, MD2, Khaled Rafeh, MD3, Amer Arman, MD4, Hebah Jaber, MD5, Noor Arman, MD6, Mazen Zamzam, BS7, Jad Bou-Abdallah, MD1 1University at Buffalo, Buffalo, NY; 2University of Jordan, Amman, 'Amman, Jordan; 3School of Medicine, The University of Jordan, Shmeisani, 'Amman, Jordan; 4MedStar Health, Washington, WA; 5Mutah University, Mutah, Al Karak, Jordan; 6University of Jordan School of Medicine, Amman, 'Amman, Jordan; 7Oakland University William Beaumont School of Medicine, Royal Oak, MI Introduction: Ulcerative colitis (UC) is a chronic inflammatory condition that significantly impairs quality of life. Biologic therapies such as Infliximab and Adalimumab, which target tumor necrosis factor alpha (TNF-α), have shown efficacy in controlling inflammation. Limited data exists that compares their efficacy in achieving biomarker-based remission. This study uses real-world data to provide a comprehensive comparison of Infliximab and Adalimumab in remission induction in UC. Methods: We conducted a retrospective cohort study using TriNetX data from 93 healthcare organizations. A total of 7,084 adult patients (≥18 years) with UC treated with Infliximab or Adalimumab between 2018 and 2023 were initially identified. Propensity score matching was performed to balance age, sex, race/ethnicity, disease severity, and comorbidities, resulting in 2,647 matched UC patients per treatment group (total n = 5,294). The primary outcome was biomarker-based remission, defined as serum C-reactive protein (CRP) ≤5 mg/L or fecal calprotectin ≤150 µg/g, and assessed at 6 months, 1 year, 3 years, and 5 years. Induction of remission rates and Kaplan-Meier survival analyses were reported for the UC cohort. Results: Infliximab demonstrated consistently higher remission rates than Adalimumab across all time points (p < 0.001). At 6 months, remission was achieved more frequently with Infliximab in UC (35.3% vs 25.4%). This pattern was held at 1 year (46.3% vs 37.1%), 3 years (61.9% vs 55.0%), and 5 years (65.9% vs 60.0%). Hazard ratios (HR) were directionally standardized to reflect Infliximab over Adalimumab (Infliximab/Adalimumab). Therefore, HR > 1 indicates faster remission with Infliximab. Infliximab was associated with a significantly shorter time to remission across all time points in UC (all HRs > 1, p < 0.001). Median time to remission was also consistently shorter with Infliximab compared to Adalimumab across the UC group. This supports the hazard ratio findings and further shows a faster induction of remission with Infliximab. Table 1 shows a detailed breakdown of these statistics. Discussion: Infliximab achieves more frequent and faster remission rates for UC at all time points. This may help guide biologic therapy selection and early treatment decisions in UC.
Figure: Table 1. Remission rates, hazard ratios, and median time to remission for Infliximab versus Adalimumab in UC patients from 6 months to 5 years.
Disclosures: Omar Arman indicated no relevant financial relationships. Laith Haj-Ahmad indicated no relevant financial relationships. Khaled Rafeh indicated no relevant financial relationships. Amer Arman indicated no relevant financial relationships. Hebah Jaber indicated no relevant financial relationships. Noor Arman indicated no relevant financial relationships. Mazen Zamzam indicated no relevant financial relationships. Jad Bou-Abdallah indicated no relevant financial relationships.
Omar Arman, MD, MPH1, Laith M.. Haj-Ahmad, MD2, Khaled Rafeh, MD3, Amer Arman, MD4, Hebah Jaber, MD5, Noor Arman, MD6, Mazen Zamzam, BS7, Jad Bou-Abdallah, MD1. P3305 - Real-World Comparison of Infliximab and Adalimumab in Achieving Biomarker-Based Remission in Ulcerative Colitis, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.
