TY - JOUR
T1 - Comparison of Short- and Long-Term Effectiveness between Anti-TNF and Ustekinumab after Vedolizumab Failure as First-Line Therapy in Crohn’s Disease
T2 - A Multi-Center Retrospective Cohort Study
AU - Albshesh, Ahmad
AU - Bannon, Lian
AU - Sharar Fischler, Tali
AU - Truyens, Marie
AU - Vavricka, Stephan R.
AU - Tepes, Katja
AU - Pugliese, Daniela
AU - Savarino, Edoardo V.
AU - Zittan, Eran
AU - Drobne, David
AU - Roblin, Xavier
AU - Bar-Gil Shitrit, Ariella
AU - Armuzzi, Alessandro
AU - Lobaton, Triana
AU - Maharshak, Nitsan
AU - Yanai, Henit
AU - Ben-Horin, Shomron
AU - Kopylov, Uri
N1 - Publisher Copyright:
© 2023 by the authors.
PY - 2023/3/26
Y1 - 2023/3/26
N2 - 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.
AB - 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.
KW - anti-TNF
KW - Crohn’s disease
KW - drug positioning
KW - treatment failure
KW - treatment response
KW - ustekinumab
KW - vedolizumab
UR - http://www.scopus.com/inward/record.url?scp=85152947865&partnerID=8YFLogxK
U2 - 10.3390/jcm12072503
DO - 10.3390/jcm12072503
M3 - Article
C2 - 37048587
AN - SCOPUS:85152947865
SN - 2077-0383
VL - 12
JO - Journal of Clinical Medicine
JF - Journal of Clinical Medicine
IS - 7
M1 - 2503
ER -