The Continental Divide: Anti-TNF Use in Pediatric IBD Is Different in North America Compared to Other Parts of the World
Table 2
Practice patterns in luminal Crohn’s disease with infliximab (IFX) and adalimumab (ADA). Results are presented as percentages or median (interquartile range) as appropriate.
North America
Europe
Elsewhere
p-value
N=183
N=103
N=58
Percentage of patients treated with anti-TNF therapy
50 (30-65)
30 (20-50)
30 (20-50)
<0.001
Anti-TNF sometimes used without IM trial
80%
38%
30%
<0.001
Percentage of time combination IM used with anti-TNF
IFX
IM-naïve
50 (10-90)
90 (20-100)
100 (60-100)
<0.001
After IM failure
80 (40-100)
98 (68-100)
90 (50-100)
0.003
ADA
IM- and IFX-naïve
25 (0-90)
80 (10-100)
20 (0-90)
0.056
after IFX LoR
75 (10-100)
90 (20-100)
55 (0-100)
0.510
Thiopurine always or usually chosen as combination IM
IFX
24%
94%
79%
<0.001
ADA
IM-naïve
20%
93%
69%
<0.001
after IFX LoR
25%
76%
68%
<0.001
Combination IM continued indefinitely
IFX
48%
16%
32%
<0.001
ADA
IM-naïve
49%
14%
11%
<0.001
after IFX LoR
54%
14%
27%
<0.001
Always adhere to standard induction
IFX
42%
66%
84%
<0.001
ADA
66%
64%
70%
0.932
anti-TNF: anti-tumour necrosis factor; IM: immunomodulator; LoR: loss of response.
