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.
Margalida Calafat, Paola Torres, Joan Tosca-Cuquerella, Rubén Sánchez-Aldehuelo, Montserrat Rivero, Marisa Iborra, María González-Vivo, Isabel Vera, Luisa de Castro, Luis Bujanda, Manuel Barreiro-de Acosta, Carlos González-Muñoza, Xavier Calvet, José Manuel Benítez, Mónica Llorente-Barrio, Gerard Surís, Fiorella Cañete, Lara Arias-García, David Monfort, Andrés Castaño-García, Francisco Javier Garcia-Alonso, José M Huguet, Ignacio Marín-Jímenez, Rufo Lorente, Albert Martín-Cardona, Juan Ángel Ferrer, Patricia Camo, Javier P Gisbert, Ramón Pajares, Fernando Gomollón, Jesús Castro-Poceiro, Jair Morales-Alvarado, Jordina Llaó, Andrés Rodríguez, Cristina Rodríguez, Pablo Pérez-Galindo, Mercè Navarro, Nuria Jiménez-García, Marta Carrillo-Palau, Isabel Blázquez-Gómez, Eva Sesé, Pedro Almela, Patricia Ramírez de la Piscina, Carlos Taxonera, Iago Rodríguez-Lago, Lidia Cabrinety, Milagros Vela, Miguel Mínguez, Francisco Mesonero, María José García, Mariam Aguas, Lucía Márquez, Marisol Silva Porto, Juan R Pineda, Koldo García-Etxebarría, Federico Bertoletti, Eduard Brunet, Míriam Mañosa, Eugeni Domènech
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引用次数: 0
Abstract
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), naïve 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.
期刊介绍：
Therapeutic Advances in Gastroenterology is an open access journal which delivers the highest quality peer-reviewed original research articles, reviews, and scholarly comment on pioneering efforts and innovative studies in the medical treatment of gastrointestinal and hepatic disorders. The journal has a strong clinical and pharmacological focus and is aimed at an international audience of clinicians and researchers in gastroenterology and related disciplines, providing an online forum for rapid dissemination of recent research and perspectives in this area.
The editors welcome original research articles across all areas of gastroenterology and hepatology.
The journal publishes original research articles and review articles primarily. Original research manuscripts may include laboratory, animal or human/clinical studies – all phases. Letters to the Editor and Case Reports will also be considered.
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