Faculty mentor/PI email address
Yschneid@virtua.org
Is your research Teaching and Learning based?
1
Keywords
Fractures, Osteoporosis, Crohns, Ulcerative Colitis, Infliximab, Adalimumab
Date of Presentation
5-6-2026 12:00 AM
Poster Abstract
Background: Biologic therapies are central to Crohn's disease (CD) management, yet the comparative effects of infliximab and adalimumab on bone health and healthcare utilization remain poorly characterized in patients without baseline vitamin D deficiency or prior fractures.
Methods: A retrospective cohort study was conducted using the TriNetX U.S. Collaborative Network. Adult CD patients (≥18 years) initiating infliximab or adalimumab between 2018–2024 were included. Patients with ulcerative colitis, indeterminate colitis, or positive pregnancy tests were excluded. All patients had normal baseline vitamin D (≥20 ng/mL) and no history of pathological fracture. Propensity score matching (1:1) yielded 7,340 patients per cohort. Outcomes over 365 days included fractures, osteoporosis, DEXA utilization, long-term steroid use, hospital visits, and vitamin D maintenance. Associations were reported as odds ratios (OR) and hazard ratios (HR).
Results: Fracture rates were low and comparable between cohorts (0.7% vs. 0.6%; OR 1.25; p=0.27). Infliximab was associated with significantly higher rates of osteoporosis (3.0% vs. 2.1%; OR 1.43; p=0.001), DEXA utilization (5.6% vs. 3.9%; OR 1.46; p< 0.001), long-term steroid use (44.3% vs. 27.9%; OR 2.06; p< 0.001), and hospital visits (24.1% vs. 20.3%; OR 1.25; p< 0.001). Adalimumab users were more likely to maintain normal vitamin D levels (2.2% vs. 0.7%; OR 0.33; p< 0.001).
Conclusions: In CD patients without baseline fractures or vitamin D deficiency, infliximab was associated with greater bone health risks and healthcare utilization compared to adalimumab, which better preserved vitamin D levels. These findings may inform biologic selection in CD management.
Disciplines
Digestive System Diseases | Medicine and Health Sciences | Nutritional and Metabolic Diseases
Bone Health and Healthcare Utilization Outcomes in Crohn’s Disease Patients Without Baseline Fracture or Vitamin D Deficiency Treated With Infliximab Versus Adalimumab: A Propensity-Matched Cohort Study
Background: Biologic therapies are central to Crohn's disease (CD) management, yet the comparative effects of infliximab and adalimumab on bone health and healthcare utilization remain poorly characterized in patients without baseline vitamin D deficiency or prior fractures.
Methods: A retrospective cohort study was conducted using the TriNetX U.S. Collaborative Network. Adult CD patients (≥18 years) initiating infliximab or adalimumab between 2018–2024 were included. Patients with ulcerative colitis, indeterminate colitis, or positive pregnancy tests were excluded. All patients had normal baseline vitamin D (≥20 ng/mL) and no history of pathological fracture. Propensity score matching (1:1) yielded 7,340 patients per cohort. Outcomes over 365 days included fractures, osteoporosis, DEXA utilization, long-term steroid use, hospital visits, and vitamin D maintenance. Associations were reported as odds ratios (OR) and hazard ratios (HR).
Results: Fracture rates were low and comparable between cohorts (0.7% vs. 0.6%; OR 1.25; p=0.27). Infliximab was associated with significantly higher rates of osteoporosis (3.0% vs. 2.1%; OR 1.43; p=0.001), DEXA utilization (5.6% vs. 3.9%; OR 1.46; p< 0.001), long-term steroid use (44.3% vs. 27.9%; OR 2.06; p< 0.001), and hospital visits (24.1% vs. 20.3%; OR 1.25; p< 0.001). Adalimumab users were more likely to maintain normal vitamin D levels (2.2% vs. 0.7%; OR 0.33; p< 0.001).
Conclusions: In CD patients without baseline fractures or vitamin D deficiency, infliximab was associated with greater bone health risks and healthcare utilization compared to adalimumab, which better preserved vitamin D levels. These findings may inform biologic selection in CD management.