Clinical and treatment outcomes of a second subcutaneous or intravenous anti-TNF in patients with ulcerative colitis treated with two consecutive anti-TNF agents: data from the ENEIDA registry

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Autores de IDIVAL

Autores ajenos al IDIVAL

  • Calafat M
  • Torres P
  • Tosca-Cuquerella J
  • Sánchez-Aldehuelo R
  • Iborra M
  • González-Vivo M
  • Vera I
  • de Castro L
  • Bujanda L
  • Barreiro-de Acosta M
  • González-Muñoza C
  • Calvet X
  • Benítez JM
  • Llorente-Barrio M
  • Surís G
  • Cañete F
  • Arias-García L
  • Monfort D
  • Castaño-García A
  • Garcia-Alonso FJ
  • Huguet JM
  • Marín-Jímenez I
  • Lorente R
  • Martín-Cardona A
  • Ferrer JÁ
  • Camo P
  • Gisbert JP
  • Pajares R
  • Gomollón F
  • Castro-Poceiro J
  • Morales-Alvarado J
  • Llaó J
  • Rodríguez A
  • Rodríguez C
  • Pérez-Galindo P
  • Navarro M
  • Jiménez-García N
  • Carrillo-Palau M
  • Blázquez-Gómez I
  • Sesé E
  • Almela P
  • Ramírez de la Piscina P
  • Taxonera C
  • Rodríguez-Lago I
  • Cabrinety L
  • Vela M
  • Mínguez M
  • Mesonero F
  • Aguas M
  • Márquez L
  • Silva Porto M
  • Pineda JR
  • García-Etxebarría K
  • Bertoletti F
  • Brunet E
  • Mañosa M
  • Domènech E

Unidades

Abstract

Background:Infliximab seems to be the most efficacious of the three available anti-TNF agents for ulcerative colitis (UC) but little is known when it is used as the second anti-TNF.Objectives:To compare the clinical and treatment outcomes of a second subcutaneous or intravenous anti-TNF in UC patients.Design:Retrospective observational study.Methods:Patients from the ENEIDA registry treated consecutively with infliximab and a subcutaneous anti-TNF (or vice versa), naive to other biological agents, were identified and grouped according to the administration route of the first anti-TNF into IVi (intravenous initially) or SCi (subcutaneous initially).Results:Overall, 473 UC patients were included (330 IVi and 143 SCi). Clinical response at week 14 was 42.7% and 48.3% in the IVi and SCi groups (non-statistically significant), respectively. Clinical remission rates at week 52 were 32.8% and 31.4% in the IVi and SCi groups (nonsignificant differences), respectively. A propensity-matched score analysis showed a higher clinical response rate at week 14 in the SCi group and higher treatment persistence in the IVi group. Regarding long-term outcomes, dose escalation and discontinuation due to the primary failure of the first anti-TNF and more severe disease activity at the beginning of the second anti-TNF were inversely associated with clinical remission.Conclusion:The use of a second anti-TNF for UC seems to be reasonable in terms of efficacy, although it is particularly reduced in the case of the primary failure of the first anti-TNF. Whether the second anti-TNF is infliximab or subcutaneous does not seem to affect efficacy. Clinical and treatment outcomes of a second subcutaneous or intravenous anti-TNF in patients with ulcerative colitis treated with two consecutive anti-TNF agents. Data from the ENEIDA registryBackground: Infliximab seems to be the most efficacious of the three available anti-TNF agents for ulcerative colitis (UC), but little is known when it is used as the second anti-TNF. Objectives: To compare the clinical and treatment outcomes of a second subcutaneous or intravenous anti-TNF in UC patients. Design: Retrospective observational study. Methods: Patients from the ENEIDA registry treated consecutively with infliximab and a subcutaneous anti-TNF (or vice versa), naive to other biological agents, were identified and grouped according to the administration route of the first anti-TNF into IVi (intravenous initially) or SCi (subcutaneous initially). Results: Overall, 473 UC patients were included (330 IVi, 143 SCi). Clinical response at week 14 was 42.7% and 48.3% in the IVi and SCi groups (non-statistically significant), respectively. Clinical remission rates at week 52 were 32.8% and 31.4%, in the IVi and SCi groups (nonsignificant differences), respectively. A propensity-matched score analysis showed a higher clinical response rate at week 14 in the SCi group and higher treatment persistence in the IVi group. Regarding long-term outcomes, dose escalation and discontinuation due to the primary failure of the first anti-TNF and more severe disease activity at the beginning of the second anti-TNF were inversely associated with clinical remission. Conclusion: The use of a second anti-TNF for UC seems to be reasonable in terms of efficacy, although it is particularly reduced in the case of the primary failure of the first anti-TNF. Whether the second anti-TNF is infliximab or subcutaneous does not seem to affect efficacy.

Datos de la publicación

ISSN/ISSNe:
1756-283X, 1756-2848

Therapeutic Advances in Gastroenterology  SAGE PUBLICATIONS LTD

Tipo:
Article
Páginas:
-
PubMed:
38187926

Citas Recibidas en Web of Science: 1

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Keywords

  • adalimumab; anti-TNF; golimumab; infliximab; switch; ulcerative colitis

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