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.

Fecha de publicación: 01/01/2024 Fecha Ahead of Print: 05/01/2024

Autores de IIS La Fe

Marisa Iborra Colomino

Autor
Javier Pérez Gisbert

Autor
Mariam Aguas Peris

Autor

Participantes ajenos a IIS La Fe

Calafat, Margalida
Torres, Paola
Tosca-Cuquerella, Joan
Sanchez-Aldehuelo, Ruben
Rivero, Montserrat
Gonzalez-Vivo, Maria
Vera, Isabel
de Castro, Luisa
Bujanda, Luis
Barreiro-de Acosta, Manuel
Gonzalez-Munoza, Carlos
Calvet, Xavier
Benitez, Jose Manuel
Llorente-Barrio, Monica
Suris, Gerard
Canete, Fiorella
Arias-Garcia, Lara
Monfort, David
Castano-Garcia, Andres
Garcia-Alonso, Francisco Javier
Huguet, Jose M
Marin-Jimenez, Ignacio
Lorente, Rufo
Martin-Cardona, Albert
Ferrer, Juan Angel
Camo, Patricia
Pajares, Ramon
Gomollon, Fernando
Castro-Poceiro, Jesus
Morales-Alvarado, Jair
Llao, Jordina
Rodriguez, Andres
Rodriguez, Cristina
Perez-Galindo, Pablo
Navarro, Merce
Jimenez-Garcia, Nuria
Carrillo-Palau, Marta
Blazquez-Gomez, Isabel
Sese, Eva
Almela, Pedro
Ramirez de la Piscina, Patricia
Taxonera, Carlos
Rodriguez-Lago, Iago
Cabrinety, Lidia
Vela, Milagros
Minguez, Miguel
Mesonero, Francisco
Garcia, Maria Jose
Marquez, Lucia
Silva Porto, Marisol
Pineda, Juan R
Garcia-Etxebarria, Koldo
Bertoletti, Federico
Brunet, Eduard
Manosa, Miriam
Domenech, Eugeni

Grupos

Enfermedad Inflamatoria Intestinal

Leader

Pilar Nos Mateu

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), 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 registry 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, 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.