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
Por:
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 J, Llorente-Barrio M, Surís G, Cañete F, Arias-García L, Monfort D, Castaño-García A, Garcia-Alonso F, Huguet J, Marín-Jímenez I, Lorente R, Martín-Cardona A, Ferrer J, Camo P, Gisbert J, 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 P, Taxonera C, Rodríguez-Lago I, Cabrinety L, Vela M, Mínguez M, Mesonero F, García M, Aguas M, Márquez L, Porto M, Pineda J, García-Etxebarría K, Bertoletti F, Brunet E, Mañosa M, Domènech E
Publicada:
1 ene 2024
Ahead of Print:
5 ene 2024
Resumen:
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.
Filiaciones:
Calafat M:
Ctr Invest Biomed Red Enfermedades Hepat & Digest, Madrid, Spain
Hosp Badalona Germans Trias & Pujol, Gastroenterol Dept, Badalona, Spain
Torres P:
Hosp Badalona Germans Trias & Pujol, Gastroenterol Dept, Badalona, Spain
Tosca-Cuquerella J:
Hosp Clin Univ Valencia, Gastroenterol Dept, Valencia, Spain
Sánchez-Aldehuelo R:
Hosp Ramon & Cajal, Gastroenterol Dept, Madrid, Spain
Rivero M:
Hosp Univ Marques De Valdecilla, Gastroenterol Dept, Santander, Spain
Inst Invest IDIVAL, Santander, Spain
Iborra M:
Hosp Univ & Politecn La Fe, Gastroenterol Dept, Valencia, Spain
González-Vivo M:
Hosp del Mar, Gastroenterol Dept, Barcelona, Spain
Vera I:
Hosp Univ Puerta de Hierro, Gastroenterol Dept, Majadahonda, Spain
de Castro L:
Complexo Hosp Univ Vigo, Gastroenterol Dept, Vigo, Spain
Bujanda L:
Ctr Invest Biomed Red Enfermedades Hepat & Digest, Madrid, Spain
Biodonostia Hlth Res Inst, San Sebastian, Spain
Univ Pais Vasco Euskal Herriko Unibertsitatea, San Sebastian, Spain
Barreiro-de Acosta M:
Complexo Hosp Univ Santiago, Gastroenterol Dept, Santiago De Compostela, Spain
González-Muñoza C:
Hosp Santa Creu & Sant Pau, Gastroenterol Dept, Barcelona, Spain
Calvet X:
Ctr Invest Biomed Red Enfermedades Hepat & Digest, Madrid, Spain
Corp Sanitaria Univ Parc Tauli, Gastroenterol Dept, Sabadell, Spain
Benítez J:
Hosp Univ Reina Sofia, Gastroenterol Dept, Cordoba, Spain
Inst Maimonides Invest Biomed Cordoba, Cordoba, Spain
Llorente-Barrio M:
Hosp Univ Miguel Servet, Gastroenterol Dept, Zaragoza, Spain
Surís G:
Hosp Univ Bellvitge, Gastroenterol Dept, Barcelona, Spain
Cañete F:
Ctr Invest Biomed Red Enfermedades Hepat & Digest, Madrid, Spain
Hosp Badalona Germans Trias & Pujol, Gastroenterol Dept, Badalona, Spain
Arias-García L:
Hosp Univ Burgos, Gastroenterol Dept, Burgos, Spain
Monfort D:
Consorci Sanitari Terrassa, Gastroenterol Dept, Terrassa, Spain
Castaño-García A:
Hosp Univ Cent Asturias, Gastroenterol Dept, Oviedo, Spain
Garcia-Alonso F:
Hosp Univ Rio Hortega, Gastroenterol Dept, Valladolid, Spain
Huguet J:
Hosp Gen Univ Valencia, Gastroenterol Dept, Valencia, Spain
Marín-Jímenez I:
Hosp Gregorio Maranon, Gastroenterol Dept, Madrid, Spain
Lorente R:
Hosp Gen Univ Ciudad Real, Gastroenterol Dept, Ciudad Real, Spain
Martín-Cardona A:
Ctr Invest Biomed Red Enfermedades Hepat & Digest, Madrid, Spain
Hosp Univ Mutua Terrassa, Gastroenterol Dept, Terrassa, Spain
Ferrer J:
Hosp Univ Fdn Alcorcon, Gastroenterol Dept, Alcorcon, Madrid, Spain
Camo P:
Hosp Gen San Jorge, Gastroenterol Dept, Huesca, Spain
Gisbert J:
Ctr Invest Biomed Red Enfermedades Hepat & Digest, Madrid, Spain
Hosp Univ La Princesa, IIS Princesa, Gastroenterol Dept, Madrid, Spain
UAM, Madrid, Spain
Pajares R:
Hosp Univ Infanta Sofia, Gastroenterol Dept, Madrid, Spain
Gomollón F:
Ctr Invest Biomed Red Enfermedades Hepat & Digest, Madrid, Spain
Hosp Clin Univ Lozano Blesa, Gastroenterol Dept, IIS Aragon, Zaragoza, Spain
Castro-Poceiro J:
Hosp Clin Barcelona, Gastroenterol Dept, Barcelona, Spain
Morales-Alvarado J:
Hosp Gen Granollers, Gastroenterol Dept, Granollers, Spain
Llaó J:
Althaia Xarxa Assistencial Manresa, Gastroenterol Dept, Manresa, Spain
Rodríguez A:
Hosp Gen Univ Alacant, Gastroenterol Dept, Alacant, Spain
Rodríguez C:
Complejo Hosp Navarra, Gastroenterol Dept, Pamplona, Spain
Pérez-Galindo P:
Complejo Hosp Univ Pontevedra, Gastroenterol Dept, Pontevedra, Spain
Navarro M:
Hosp Moises Broggi, Gastroenterol Dept, St Joan Despi, Spain
Jiménez-García N:
Hosp Gen Univ Elx, Gastroenterol Dept, Elx, Spain
Carrillo-Palau M:
Hosp Univ Canarias, Gastroenterol Dept, San Cristobal la Laguna, Spain
Blázquez-Gómez I:
Hosp Univ Torrejon, Gastroenterol Dept, Torrejon, Spain
Sesé E:
Hosp Arnau Vilanova, Gastroenterol Dept, Lleida, Spain
Almela P:
Hosp Gen Univ Castello, Gastroenterol Dept, Castellon de La Plana, Spain
de la Piscina P:
Hosp Univ Alava, Gastroenterol Dept, Vitoria, Spain
Taxonera C:
Hosp Clin San Carlos, Gastroenterol Dept, Madrid, Spain
Rodríguez-Lago I:
Hosp Univ Galdakao, Gastroenterol Dept, Biocruces Bizkaia HRI, Galdakao, Spain
Cabrinety L:
Hosp Univ Joan XXIII, Gastroenterol Dept, Tarragona, Spain
Vela M:
Hosp Univ Nuestra Senora Candelaria, Gastroenterol Dept, Santa Cruz De Tenerife, Spain
Mínguez M:
Hosp Badalona Germans Trias & Pujol, Gastroenterol Dept, Badalona, Spain
Hosp Clin Univ Valencia, Gastroenterol Dept, Valencia, Spain
Mesonero F:
Hosp Ramon & Cajal, Gastroenterol Dept, Madrid, Spain
García M:
Hosp Univ Marques De Valdecilla, Gastroenterol Dept, Santander, Spain
Inst Invest IDIVAL, Santander, Spain
Aguas M:
Hosp Univ & Politecn La Fe, Gastroenterol Dept, Valencia, Spain
Márquez L:
Hosp del Mar, Gastroenterol Dept, Barcelona, Spain
Porto M:
Hosp Univ Puerta de Hierro, Gastroenterol Dept, Majadahonda, Spain
Pineda J:
Complexo Hosp Univ Vigo, Gastroenterol Dept, Vigo, Spain
García-Etxebarría K:
Ctr Invest Biomed Red Enfermedades Hepat & Digest, Madrid, Spain
Biodonostia Hlth Res Inst, San Sebastian, Spain
Univ Pais Vasco Euskal Herriko Unibertsitatea, San Sebastian, Spain
Bertoletti F:
Hosp Santa Creu & Sant Pau, Gastroenterol Dept, Barcelona, Spain
Brunet E:
Ctr Invest Biomed Red Enfermedades Hepat & Digest, Madrid, Spain
Corp Sanitaria Univ Parc Tauli, Gastroenterol Dept, Sabadell, Spain
Mañosa M:
Ctr Invest Biomed Red Enfermedades Hepat & Digest, Madrid, Spain
Domènech E:
Hosp Badalona Germans Trias & Pujol, Gastroenterol Dept, Badalona, Spain
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