Effectiveness and Safety of the Sequential Use of a Second and Third Anti-TNF Agent in Patients With Inflammatory Bowel Disease: Results From the Eneida Registry

BACKGROUND: The effectiveness of the switch to another anti-tumor necrosis factor (anti-TNF) agent is not known. The aim of this study was to analyze the effectiveness and safety of treatment with a second and third anti-TNF drug after intolerance to or failure of a previous anti-TNF agent in inflam...

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Autores: Casanova, Maria Jose, Chaparro, Maria, Minguez, Miguel, Ricart, Elena, Taxonera, Carlos, Garcia-Lopez, Santiago, Guardiola, Jordi, Lopez-San Roman, Antonio, Iglesias, Eva, Beltran, Belen, Sicilia, Beatriz, Vera, Maria Isabel, Hinojosa, Joaquin, Riestra, Sabino, Domenech, Eugeni, Calvet, Xavier, Perez-Calle, Jose Lazaro, Martin-Arranz, Maria Dolores, Aldeguer, Xavier, Rivero, Montserrat, Monfort, David, Barrio, Jesus, Esteve, Maria, Marquez, Lucia, Lorente, Rufo, Garcia-Planella, Esther, de Castro, Luisa, Bermejo, Fernando, Merino, Olga, Rodriguez-Perez, Antonio, Martinez-Montiel, Pilar, Van Domselaar, Manuel, Alcain, Guillermo, Dominguez-Cajal, Manuel, Munoz, Carmen, Gomollon, Fernando, Fernandez-Salazar, Luis, Garcia-Sepulcre, Mariana Fe, Rodriguez-Lago, Iago, Gutierrez, Ana, Arguelles-Arias, Federico, Rodriguez, Cristina, Rodriguez, Gloria Esther, Bujanda, Luis, Llao, Jordina, Varela, Pilar, Ramos, Laura, Huguet, Jose Maria, Almela, Pedro, Romero, Patricia, Navarro-Llavat, Merce, Abad, Agueda, Ramirez-de la Piscina, Patricia, Lucendo, Alfredo J, Sese, Eva, Madrigal, Rosa Eva, Charro, Mara, Garcia-Herola, Antonio, Pajares, Ramon, Khorrami, Sam, Gisbert, Javier P
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2020
País:España
Institución:INCLIVA
Repositorio:r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
OAI Identifier:oai:incliva.fundanetsuite.com:p4019
Acceso en línea:https://incliva.portalinvestigacion.com/publicaciones/4019
Access Level:acceso abierto
Palabra clave:inflammatory bowel disease
Crohn's disease
ulcerative colitis
anti-TNF
switch
Descripción
Sumario:BACKGROUND: The effectiveness of the switch to another anti-tumor necrosis factor (anti-TNF) agent is not known. The aim of this study was to analyze the effectiveness and safety of treatment with a second and third anti-TNF drug after intolerance to or failure of a previous anti-TNF agent in inflammatory bowel disease (IBD) patients.; METHODS: We included patients diagnosed with IBD from the ENEIDA registry who received another anti-TNF after intolerance to or failure of a prior anti-TNF agent.; RESULTS: A total of 1122 patients were included. In the short term, remission was achieved in 55% of the patients with the second anti-TNF. The incidence of loss of response was 19% per patient-year with the second anti-TNF. Combination therapy (hazard ratio [HR], 2.4; 95% confidence interval [CI], 1.8-3; P < 0.0001) and ulcerative colitis vs Crohn's disease (HR, 1.6; 95% CI, 1.1-2.1; P = 0.005) were associated with a higher probability of loss of response. Fifteen percent of the patients had adverse events, and 10% had to discontinue the second anti-TNF. Of the 71 patients who received a third anti-TNF, 55% achieved remission. The incidence of loss of response was 22% per patient-year with a third anti-TNF. Adverse events occurred in 7 patients (11%), but only 1 stopped the drug.; CONCLUSIONS: Approximately half of the patients who received a second anti-TNF achieved remission; nevertheless, a significant proportion of them subsequently lost response. Combination therapy and type of IBD were associated with loss of response. Remission was achieved in almost 50% of patients who received a third anti-TNF; nevertheless, a significant proportion of them subsequently lost response. © 2019 Crohns & Colitis Foundation. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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