Details

Autor(en) / Beteiligte

• Casanova, María José
• Chaparro, María
• Mínguez, Miguel
• Ricart, Elena
• Taxonera, Carlos
• García-López, Santiago
• Guardiola, Jordi
• López-San Román, Antonio
• Iglesias, Eva
• Beltrán, Belén
• Sicilia, Beatriz
• Vera, María Isabel
• Hinojosa, Joaquín
• Riestra, Sabino
• Domènech, Eugeni
• Calvet, Xavier
• Pérez-Calle, José Lázaro
• Martín-Arranz, María Dolores
• Aldeguer, Xavier
• Rivero, Montserrat
• Monfort, David
• Barrio, Jesús
• Esteve, María
• Márquez, Lucía
• Lorente, Rufo
• García-Planella, Esther
• de Castro, Luisa
• Bermejo, Fernando
• Merino, Olga
• Rodríguez-Pérez, Antonio
• Martínez-Montiel, Pilar
• Van Domselaar, Manuel
• Alcaín, Guillermo
• Domínguez-Cajal, Manuel
• Muñoz, Carmen
• Gomollón, Fernando
• Fernández-Salazar, Luis
• García-Sepulcre, Mariana Fe
• Rodríguez-Lago, Iago
• Gutiérrez, Ana
• Argüelles-Arias, Federico
• Rodriguez, Cristina
• Rodríguez, Gloria Esther
• Bujanda, Luis
• Llaó, Jordina
• Varela, Pilar
• Ramos, Laura
• Huguet, José María
• Almela, Pedro
• Romero, Patricia
• Navarro-Llavat, Mercè
• Abad, Águeda
• Ramírez-de la Piscina, Patricia
• Lucendo, Alfredo J
• Sesé, Eva
• Madrigal, Rosa Eva
• Charro, Mara
• García-Herola, Antonio
• Pajares, Ramón
• Khorrami, Sam
• Gisbert, Javier P

Titel

Effectiveness and Safety of the Sequential Use of a Second and Third Anti-TNF Agent in Patients With Inflammatory Bowel Disease: Results From the Eneida Registry

Ist Teil von

• Inflammatory bowel diseases, 2020-03, Vol.26 (4), p.606-616

Ort / Verlag

US: Oxford University Press

Erscheinungsjahr

2020

Link zum Volltext

Quelle

Oxford Journals 2020 Medicine

Beschreibungen/Notizen

• Abstract Background The effectiveness of the switch to another anti–tumor necrosis factor (anti-TNF) agent is not known. The aim of this study was to analyze the effectiveness and safety of treatment with a second and third anti-TNF drug after intolerance to or failure of a previous anti-TNF agent in inflammatory bowel disease (IBD) patients. Methods We included patients diagnosed with IBD from the ENEIDA registry who received another anti-TNF after intolerance to or failure of a prior anti-TNF agent. Results A total of 1122 patients were included. In the short term, remission was achieved in 55% of the patients with the second anti-TNF. The incidence of loss of response was 19% per patient-year with the second anti-TNF. Combination therapy (hazard ratio [HR], 2.4; 95% confidence interval [CI], 1.8–3; P < 0.0001) and ulcerative colitis vs Crohn’s disease (HR, 1.6; 95% CI, 1.1–2.1; P = 0.005) were associated with a higher probability of loss of response. Fifteen percent of the patients had adverse events, and 10% had to discontinue the second anti-TNF. Of the 71 patients who received a third anti-TNF, 55% achieved remission. The incidence of loss of response was 22% per patient-year with a third anti-TNF. Adverse events occurred in 7 patients (11%), but only 1 stopped the drug. Conclusions Approximately half of the patients who received a second anti-TNF achieved remission; nevertheless, a significant proportion of them subsequently lost response. Combination therapy and type of IBD were associated with loss of response. Remission was achieved in almost 50% of patients who received a third anti-TNF; nevertheless, a significant proportion of them subsequently lost response. Almost half of the 1122 patients who switched to a second anti-TNF after primary failure, secondary failure, or intolerance to the first anti-TNF achieved remission after switching. Factors associated with loss of response were type of IBD and combo therapy.