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

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 patien...

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Detalhes bibliográficos
Autores: 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
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2024
País:España
Recursos:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
Repositorio:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
OAI Identifier:oai:iibsantpau.fundanetsuite.com:p17407
Acesso em linha:https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=17407
https://ddd.uab.cat/record/302205
Access Level:acceso abierto
Palavra-chave:adalimumab
anti-TNF
golimumab
infliximab
switch
ulcerative colitis
Descrição
Resumo: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.

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