Is infliximab more effective than adalimumab at inducing clinical remission of metastatic cutaneous Crohn's lesions

What is known

- Metastatic cutaneous Crohn's lesions have responded to infliximab across multiple case reports, sometimes with concomitant methotrexate or antibiotics. ^1–3 - Adalimumab has also shown efficacy in inducing and maintaining remission of metastatic Crohn's lesions, with case reports describing complete resolution of subcutaneous and cutaneous lesions. ^1,4 - In one reported case a patient responded to infliximab but discontinued for an allergic reaction, then failed to achieve remission on adalimumab before responding to ustekinumab. ⁵

What is unknown / caveats

- Evidence limited to case reports and reviews, no comparative or controlled data - No study directly compares infliximab and adalimumab for metastatic cutaneous Crohn's disease - Whether either agent is more effective than the other for these lesions cannot be determined from the available reports.

## References

1. Aberumand B, Howard J, Howard J. Metastatic Crohn's Disease: An Approach to an Uncommon but Important Cutaneous Disorder. Biomed Res Int. 2017. PMID: 28127561.

2. Martín de Carpi J, Chávez Caraza K, Vicente Villa MA, González Enseñat MA, Vilar Escrigas P, Vila Miravet V, Guallarte Alias P, Varea Calderón V. [Skin manifestations of pediatric inflammatory bowel disease]. An Pediatr (Barc). 2009;70(6):570-7. PMID: 19446510.

3. Letzelter M, Andrianjafy C, Marin S, Rocour S, De Ybarlucea LR, Maillard H. [Metastatic Crohn's disease of the umbilicus: An exceptional location]. Rev Med Interne. 2022. PMID: 34362570.

4. Alotaibi HM, Fathaddin AA, AlMutairi HM, Barakeh MM. Metastatic Crohn's Disease in External Genitalia With Good Outcome on Adalimumab: A Rare Case of a Saudi Female and a Short Review. Cureus. 2023;15(8):e43380. PMID: 37700991.

5. Elger T, Loibl J, Buechler C, Haferkamp S, Werner J, Drexler K, Hohenleutner U, Guelow K, Kunst C, Kandulski A, Goeggelmann P, Mueller M, Tews HC. Fistulising skin metastases in Crohn's disease: a case report and review of the literature. J Med Case Rep. 2024. PMID: 38762485.

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_Draft, generated by the IBDology RAG and not yet clinician-reviewed. Answers are grounded in the retrieved literature listed above; a high faithfulness score means the answer matches its sources, not that the sources are correct._