1. 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
- Author
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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, and Eugeni Domènech
- Subjects
Diseases of the digestive system. Gastroenterology ,RC799-869 - 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.
- Published
- 2024
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