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

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:R...

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Autores: Calafat, Margalida, Torres, Paola, Tosca Cuquerella, Joan, Sánchez Aldehuelo, Rubén, Rivero, Montserrat, Iborra, Marisa, González Vivó, María, Vera, Isabel, Castro, Luisa de, Bujanda, Luis, Barreiro de Acosta, Manuel, González Muñoza, Carlos, Calvet, Xavier, Benítez, José Manuel, Llorente Barrio, Mónica, Surís, Gerard, Cañete, Fiorella, Arias García, Lara, Monfort, David, Castaño García, Andrés, Garcia Alonso, Francisco Javier, Huguet, José María, Marín Jiménez, Ignacio, Lorente, Rufo, Martín Cardona, Albert, Ferrer, Juan Ángel, Camo, Patricia, Gisbert, Javier P., Pajares, Ramón, Gomollón, Fernando, Castro Poceiro, Jesús, Morales Alvarado, Jair, Llaó, Jordina, Rodríguez, Andrés, Rodríguez, Cristina, Pérez Galindo, Pablo, Navarro, Mercè, Jiménez García, Nuria, Carrillo Palau, Marta, Blázquez Gómez, Isabel, Sesé, Eva, Almela, Pedro, Ramírez de la Piscina, Patricia, Taxonera, Carlos, Rodríguez Lago, Iago, Cabrinety, Lidia, Vela, Milagros, Mínguez, Miguel, Mesonero, Francisco, García, María José, Aguas, Mariam, Márquez, Lucía, Silva Porto, Marisol, Pineda, Juan R., García Etxebarría, Koldo, Bertoletti, Federico, Brunet, Eduard, Mañosa, Míriam, Domènech, Eugeni
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2024
País:España
Institución:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/207684
Acceso en línea:https://hdl.handle.net/2445/207684
Access Level:acceso abierto
Palabra clave:Colitis ulcerosa
Teràpia intravenosa
Ulcerative colitis
Intravenous therapy
Descripción
Sumario: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.

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