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

Ahmad Albshesh, Lian Bannon, Tali Sharar Fischler, Marie Truyens, Stephan R. Vavricka, Katja Tepes, Daniela Pugliese, Edoardo V. Savarino, Eran Zittan, David Drobne, Xavier Roblin, Ariella Bar-Gil Shitrit, Alessandro Armuzzi, Triana Lobaton, Nitsan Maharshak, Henit Yanai, Shomron Ben-Horin, Uri Kopylov

Research output: Contribution to journalArticlepeer-review

Abstract

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: 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: 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%, p = 0.8 and 48.3% vs. 56%, p = 0.8 on anti-TNF and UST therapy, respectively. Furthermore, in the maintenance period the rate was similar: 75% vs. 82.3%, p = 0.8 and 62.5% vs. 70.5%, p = 0.8, respectively. Of the patients, 12 out of the 59 stopped the therapy, without a significant difference between the two groups (p = 0.6). Conclusion: 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.

Original languageEnglish
Article number2503
JournalJournal of Clinical Medicine
Volume12
Issue number7
DOIs
StatePublished - 26 Mar 2023
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2023 by the authors.

Keywords

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

ASJC Scopus subject areas

  • General Medicine

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