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Based on Kaplan–Meier analysis, the survival time for infliximab is comparatively longer than that for adalimumab; however, there are no significant differences between the two drugs based on retention rate, with their efficacy diminishing over time.

Psoriasis can be described as a chronic immune-mediated disorder that requires lifelong treatment. A drug’s survival and retention rates determine its safety and efficacy. This retrospective study assessed the long-term survival rates for two tumor necrosis factor (TNF) inhibitors, infliximab and adalimumab. The study concluded that the overall efficacy of these drugs diminished over time with a concomitant decline in patient retention. The results also suggest that the survival time for infliximab is longer than that for adalimumab. The study findings were published in the journal Dermatology.

Comparison of Infliximab and Adalimumab Effectiveness in Treating Psoriasis

This study demonstrated that the effectiveness of infliximab was superior to that of adalimumab initially; however, it diminished over time. This is based on the high rate of secondary ineffectiveness for infliximab, which was observed in 77.9% of patients taking this drug, compared with a 24% rate of secondary ineffectiveness for adalimumab. This difference was statistically significant, with a P value < 0.001.

Infliximab Outperforms Adalimumab in Long-Term Survival

The survival time was recorded to be 121.6 and 78.8 months in patients administered infliximab and adalimumab, respectively. There was a greater number of biologic-naïve patients present in the adalimumab group compared to the infliximab group; however, this difference was not statistically significant.

Continuation Rates of Infliximab and Adalimumab

This study also demonstrated the continuation of treatment in each group. In the infliximab treatment group, 75.6% of patients used the drug for < 5 years and 75% of patients in the adalimumab group discontinued use within 5 years.

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The Overall Retention Rates of Drugs Are Similar Across the Treatment Groups

The overall retention rates of the drugs after 10 years were 3% and 7% in the adalimumab and infliximab treatment groups, respectively. The retention across 10+ years was high in both treatment groups. Thirty (17%) individuals used infliximab for 5–10 years and 13 (7.4%) for more than 10 years, while 49 individuals (21.5%) used adalimumab for 5–10 years and 8 (3.5%) for more than 10 years. 

Shorter Infusion Intervals and Combination Therapies Show Improved Results

This study demonstrated that shortening the infusion interval to 6 weeks in four patients who were administered infliximab improved the drug efficacy. Moreover, concomitant MTX treatment in 32 adalimumab and 79 infliximab group participants, or concomitant acitretin treatment in 8 adalimumab and 11 infliximab group participants also increased the treatment efficacy.

The study concluded that efficacy of theTNF inhibitors infliximab and adalimumab diminished over time, with a longer survival time in the infliximab group compared to that in the adalimumab group. The study suggested that TNF inhibitors are therapeutically effective for short-term relief only.

Source

Onsun, N., Güneş, B., Kaya, G., Güçkan Işık, B., & Yabacı Tak, A. (2023). Comparison of Survival and Retention Rates between Infliximab and Adalimumab for Psoriasis: 10-year Experience at a Single Tertiary Center. Dermatology. https://doi.org/10.1159/000529964