1. Treatment persistence of ustekinumab and vedolizumab in IBD patients is independent of prior immunogenicity to anti-TNFs: a retrospective study.
- Author
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Blesl, Andreas, Petritsch, Wolfgang, Binder, Lukas, Fürst, Stefan, Wenzl, Heimo, Baumann-Durchschein, Franziska, Kump, Patrizia, and Högenauer, Christoph
- Subjects
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IMMUNE response , *CROHN'S disease , *VEDOLIZUMAB , *TERMINATION of treatment , *ULCERATIVE colitis - Abstract
Immunological treatment failure of anti-TNF therapy negatively influences treatment persistence of a second anti-TNF in IBD patients. So far it is unknown if this effect is also observed for other monoclonal antibodies. We assessed the influence of immunogenicity to anti-TNFs on treatment persistence of subsequent ustekinumab and vedolizumab therapy. IBD patients with and without immunogenicity to anti-TNFs (undetectable trough levels and antibody titers ≥20 ng/mL) and subsequent ustekinumab (UST) and/or vedolizumab (VDZ) therapy were included in this retrospective, single-center study. The Kaplan-Meier method with the log-rank test and Cox proportional hazards were used as statistical methods. One hundred patients (Crohn's disease: 62, Ulcerative colitis: 31, IBD unclassified: 7) with 127 treatment lines (62 with UST, 65 with VDZ) were included in the analysis. Immunogenicity to previous anti-TNFs did not influence treatment persistence of subsequent ustekinumab and vedolizumab therapy (UST: Log rank: p =.95, Immunogenicity: HR for treatment discontinuation: 0.97 [95% CI 0.31–3.04]; VDZ: p =.65, HR: 0.85 [0.41–1.75]; total cohort [UST and VDZ]: p =.62, HR: 0.86 [0.47–1.57]). Azathioprine co-treatment did not lengthen treatment persistence (UST: Log rank: p =.77, azathioprine: HR: 1.20 [0.34–4.27]; VDZ: p =.92, HR: 0.58 [0.17–1.99]; total cohort: p =.79, HR: 1.10 [0.55–2.20]). In this anti-TNF experienced cohort, patients with ustekinumab remained longer on treatment than patients receiving vedolizumab (Log rank: p =.005, UST: HR: 0.43 [0.23–0.79]). Immunogenicity to anti-TNFs does not influence treatment persistence of subsequent ustekinumab and vedolizumab therapy. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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