Comparison of Short- and Long-Term Effectiveness between Anti-TNF and Ustekinumab after Vedolizumab Failure as First-Line Therapy in Crohn's Disease: A Multi-Center Retrospective Cohort Study.

Crohn’s disease anti-TNF drug positioning treatment failure treatment response ustekinumab vedolizumab

Journal

Journal of clinical medicine
ISSN: 2077-0383
Titre abrégé: J Clin Med
Pays: Switzerland
ID NLM: 101606588

Informations de publication

Date de publication:
26 Mar 2023
Historique:
received: 29 01 2023
revised: 14 03 2023
accepted: 24 03 2023
medline: 14 4 2023
entrez: 13 4 2023
pubmed: 14 4 2023
Statut: epublish

Résumé

The effectiveness of anti-TNF or ustekinumab (UST) as a second-line biologic after vedolizumab (VDZ) failure has not yet been described. In this retrospective multicenter cohort study, We aim to investigate the effectiveness of anti-TNF and UST as second-line therapy in patients with Crohn's disease (CD) who failed VDZ as a first-line treatment. The primary outcome was clinical response at week 16-22. Secondary outcomes included the rates of clinical remission, steroid-free clinical remission, CRP normalization, and adverse events. Fifty-nine patients who failed on VDZ as a first-line treatment for CD were included; 52.8% patients received anti-TNF and 47.2% UST as a second-line therapy. In initial period (Week 16-22), the clinical response and remission rate was similar between both groups: 61.2% vs. 68%, Second-line biological therapy after VDZ failure therapy was effective in >60% of the patients with CD. No differences in effectiveness were detected between the use of anti-TNF and UST as a second line.

Sections du résumé

BACKGROUND BACKGROUND
The effectiveness of anti-TNF or ustekinumab (UST) as a second-line biologic after vedolizumab (VDZ) failure has not yet been described.
AIMS AND METHODS OBJECTIVE
In this retrospective multicenter cohort study, We aim to investigate the effectiveness of anti-TNF and UST as second-line therapy in patients with Crohn's disease (CD) who failed VDZ as a first-line treatment. The primary outcome was clinical response at week 16-22. Secondary outcomes included the rates of clinical remission, steroid-free clinical remission, CRP normalization, and adverse events.
RESULTS RESULTS
Fifty-nine patients who failed on VDZ as a first-line treatment for CD were included; 52.8% patients received anti-TNF and 47.2% UST as a second-line therapy. In initial period (Week 16-22), the clinical response and remission rate was similar between both groups: 61.2% vs. 68%,
CONCLUSION CONCLUSIONS
Second-line biological therapy after VDZ failure therapy was effective in >60% of the patients with CD. No differences in effectiveness were detected between the use of anti-TNF and UST as a second line.

Identifiants

pubmed: 37048587
pii: jcm12072503
doi: 10.3390/jcm12072503
pmc: PMC10095015
pii:
doi:

Types de publication

Journal Article

Langues

eng

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Auteurs

Ahmad Albshesh (A)

Sheba Medical Center, Department of Gastroenterology, Tel Hashomer, Ramat Gan 5262100, Israel.
Sackler School of Medicine, Tel-Aviv University, Tel-Aviv 52621, Israel.

Lian Bannon (L)

Sackler School of Medicine, Tel-Aviv University, Tel-Aviv 52621, Israel.
Tel Aviv Medical Center, Department of Gastroenterology and Liver Diseases, Tel-Aviv 6423906, Israel.

Tali Sharar Fischler (T)

Rabin Medical Center, Division of Gastroenterology, Department of Gastroenterology, Petah Tikva 49100, Israel.

Marie Truyens (M)

IBD Unit, Department of Gastroenterology, Ghent University Hospital, 9000 Ghent, Belgium.

Stephan R Vavricka (SR)

Division of Gastroenterology and Hepatology, University Hospital, CH-8048 Zurich, Switzerland.

Katja Tepes (K)

General Hospital Celje, 3000 Celje, Slovenia.

Daniela Pugliese (D)

IBD Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy.

Edoardo V Savarino (EV)

Division of Gastroenterology, Department of Surgery, Oncology and Gastroenterology, University of Padua, 35128 Padua, Italy.

Eran Zittan (E)

Abraham and Sonia Rochlin IBD Unit, Department of Gastroenterology, Emek Medical Center, Afula 1834111, Israel.
Rappaport Faculty of Medicine Technion, Israel Institute of Technology, Haifa 3200003, Israel.

David Drobne (D)

Department of Gastroenterology, University Medical Centre Ljubljana, 1231 Ljubljana, Slovenia.
Medical Faculty, University of Ljubljana, 1231 Ljubljana, Slovenia.

Xavier Roblin (X)

Service de Gastrologie-Entérologie-Hépatologie, CHU de Saint-Etienne, 42270 Saint-Etienne, France.

Ariella Bar-Gil Shitrit (A)

Shaare Zedek Medical Center, Digestive Diseases Institute, Jerusalem 9103102, Israel.
Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9372212, Israel.

Alessandro Armuzzi (A)

IBD Center, IRCCS Humanitas Research Hospital, Rozzano, 35128 Milan, Italy.
Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20090 Milan, Italy.

Triana Lobaton (T)

IBD Unit, Department of Gastroenterology, Ghent University Hospital, 9000 Ghent, Belgium.

Nitsan Maharshak (N)

Sackler School of Medicine, Tel-Aviv University, Tel-Aviv 52621, Israel.
Tel Aviv Medical Center, Department of Gastroenterology and Liver Diseases, Tel-Aviv 6423906, Israel.

Henit Yanai (H)

Sackler School of Medicine, Tel-Aviv University, Tel-Aviv 52621, Israel.
Rabin Medical Center, Division of Gastroenterology, Department of Gastroenterology, Petah Tikva 49100, Israel.

Shomron Ben-Horin (S)

Sheba Medical Center, Department of Gastroenterology, Tel Hashomer, Ramat Gan 5262100, Israel.
Sackler School of Medicine, Tel-Aviv University, Tel-Aviv 52621, Israel.

Uri Kopylov (U)

Sheba Medical Center, Department of Gastroenterology, Tel Hashomer, Ramat Gan 5262100, Israel.
Sackler School of Medicine, Tel-Aviv University, Tel-Aviv 52621, Israel.

Classifications MeSH