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
Por:
Calafat, M, Torres, P, Tosca-Cuquerella, J, Sánchez-Aldehuelo, R, Rivero, M, 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, JA, 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, de la Piscina, PR, Taxonera, C, Rodríguez-Lago, I, Cabrinety, L, Vela, M, Mínguez, M, Mesonero, F, García, MJ, Aguas, M, Márquez, L, Porto, MS, Pineda, JR, García-Etxebarría, K, Bertoletti, F, Brunet, E, Mañosa, M, Domènech, E
Publicada:
1 ene 2024
Resumen:
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.
Filiaciones:
Hosp Gen Univ Valencia, Gastroenterol Dept, Valencia, Spain
Hosp Gregorio Maranon, Gastroenterol Dept, Madrid, Spain
Hosp Gen Univ Ciudad Real, Gastroenterol Dept, Ciudad Real, Spain
Hosp Univ Mutua Terrassa, Gastroenterol Dept, Terrassa, Spain
Hosp Univ Fdn Alcorcon, Gastroenterol Dept, Alcorcon, Madrid, Spain
Hosp Gen San Jorge, Gastroenterol Dept, Huesca, Spain
Hosp Univ La Princesa, IIS Princesa, Gastroenterol Dept, Madrid, Spain
UAM, Madrid, Spain
Hosp Univ Infanta Sofia, Gastroenterol Dept, Madrid, Spain
Hosp Clin Univ Lozano Blesa, Gastroenterol Dept, IIS Aragon, Zaragoza,
Hosp Clin Barcelona, Gastroenterol Dept, Barcelona, Spain
Hosp Gen Granollers, Gastroenterol Dept, Granollers, Spain
Althaia Xarxa Assistencial Manresa, Gastroenterol Dept, Manresa, Spain
Hosp Gen Univ Alacant, Gastroenterol Dept, Alacant, Spain
Complejo Hosp Navarra, Gastroenterol Dept, Pamplona, Spain
Complejo Hosp Univ Pontevedra, Gastroenterol Dept, Pontevedra, Spain
Hosp Moises Broggi, Gastroenterol Dept, St Joan Despi, Spain
Hosp Gen Univ Elx, Gastroenterol Dept, Elx, Spain
Hosp Univ Canarias, Gastroenterol Dept, San Cristobal la Laguna, Spain
Hosp Univ Torrejon, Gastroenterol Dept, Torrejon, Spain
Hosp Arnau Vilanova, Gastroenterol Dept, Lleida, Spain
Hosp Gen Univ Castello, Gastroenterol Dept, Castellon de La Plana, Spain
Hosp Univ Alava, Gastroenterol Dept, Vitoria, Spain
Hosp Clin San Carlos, Gastroenterol Dept, Madrid, Spain
Hosp Univ Galdakao, Gastroenterol Dept, Biocruces Bizkaia HRI, Galdakao,
Hosp Univ Joan XXIII, Gastroenterol Dept, Tarragona, Spain
Hosp Univ Nuestra Senora Candelaria, Gastroenterol Dept, Santa Cruz De
Tenerife, Spain
Hosp Univ Rio Hortega, Gastroenterol Dept, Valladolid, Spain
Hosp Univ Cent Asturias, Gastroenterol Dept, Oviedo, Spain
Consorci Sanitari Terrassa, Gastroenterol Dept, Terrassa, Spain
Hosp Univ Burgos, Gastroenterol Dept, Burgos, Spain
Hosp Univ Bellvitge, Gastroenterol Dept, Barcelona, Spain
Hosp Univ Miguel Servet, Gastroenterol Dept, Zaragoza, Spain
Inst Maimonides Invest Biomed Cordoba, Cordoba, Spain
Hosp Univ Reina Sofia, Gastroenterol Dept, Cordoba, Spain
Corp Sanitaria Univ Parc Tauli, Gastroenterol Dept, Sabadell, Spain
Hosp Santa Creu & Sant Pau, Gastroenterol Dept, Barcelona, Spain
Spain
Complexo Hosp Univ Santiago, Gastroenterol Dept, Santiago De Compostela,
Univ Pais Vasco Euskal Herriko Unibertsitatea, San Sebastian, Spain
Biodonostia Hlth Res Inst, San Sebastian, Spain
Complexo Hosp Univ Vigo, Gastroenterol Dept, Vigo, Spain
Hosp Univ Puerta de Hierro, Gastroenterol Dept, Majadahonda, Spain
Hosp del Mar, Gastroenterol Dept, Barcelona, Spain
Hosp Univ & Politecn La Fe, Gastroenterol Dept, Valencia, Spain
Inst Invest IDIVAL, Santander, Spain
Hosp Univ Marques de Valdecilla, Gastroenterol Dept, Santander, Spain
Hosp Ramon & Cajal, Gastroenterol Dept, Madrid, Spain
Hosp Clin Univ Valencia, Gastroenterol Dept, Valencia, Spain
Hosp Badalona Germans Trias & Pujol, Gastroenterol Dept, Badalona, Spain
Ctr Invest Biomed Red Enfermedades Hepat & Digest, Madrid, Spain
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