Effectiveness of adalimumab versus infliximab in patients with ankylosing spondylitis: A randomized double blinded clinical trial

Objective: To compare the efficacy of Adalimumab versus Infliximab in patients with active Ankylosing Spondylitis. Method: 80 patients with active AS who were candidates for receiving anti TNF drugs were randomly assigned to Adalimumab receiving group (group A) or Infliximab receiving group (group B). At beginning, BASDAI score, ESR level, CRP level, presence or absence of peripheral arthritis and enthesitis, need for NSAID use, schober test and occiput to wall distance were recorded. A second rheumatologist who was unaware of the type of drug used, evaluated patients 2 months and 4 months after initiating treatment and new data was recorded. Data were analyzed using SPSS software version 26 with T-test, Mann-Whitney U test, Chi-squared test, McNemar and Wilcoxon test. Results: after 2 and 4 months treatment, patients of both groups showed significant improvement in the BASDAI score, ESR level, CRP level and Schober test. They all needed less NSAID to control their pain. Both drugs had similar effects on clinical and laboratory variables. Conclusion: Adalimumab and Infliximab are both effective for improving clinical and physical status and quality of life in patients with active AS. Since there is no significant difference for the effectiveness of these 2 drugs, accessibility, price and administration of these drugs can help physicians decide between these drugs.