Title :

Efficacy of ustekinumab, vedolizumab, or a second anti-TNF agent after the failure of a first anti-TNF agent in patients with Crohn's disease: a multicentre retrospective study.

Author(s) :

Rayer, Cassandra [Auteur]
Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
Nachury, Maria [Auteur]
Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286
Bourreille, Arnaud [Auteur]
Centre Hospitalier Universitaire de Nantes = Nantes University Hospital [CHU Nantes]
Roblin, Xavier [Auteur]
Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] [CHU ST-E]
Peyrin-Biroulet, Laurent [Auteur]
Nutrition-Génétique et Exposition aux Risques Environnementaux [NGERE]
Viennot, Stéphanie [Auteur]
CHU Caen
Flamant, Mathurin [Auteur]
Laharie, David [Auteur]
CHU Bordeaux
Caron, Bénédicte [Auteur]
Nutrition-Génétique et Exposition aux Risques Environnementaux [NGERE]
Dewitte, Marie [Auteur]
Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
Siproudhis, Laurent [Auteur]
Centre d'Investigation Clinique [Rennes] [CIC]
Nutrition, Métabolismes et Cancer [NuMeCan]
Fumery, Mathurin [Auteur]
Périnatalité et Risques Toxiques - UMR INERIS_I 1 UPJV [PERITOX]
Bouguen, Guillaume [Auteur]
Nutrition, Métabolismes et Cancer [NuMeCan]

Journal title :

BMC Gastroenterology

Abbreviated title :

BMC Gastroenterol

Volume number :

22

Pages :

498

Publication date :

2022-12-10

ISSN :

1471-230X

English keyword(s) :

Crohn's disease
Anti-TNF
Vedolizumab
Ustekinumab
Treatment strategy
Second line

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Background No study has performed a face-to-face comparison of biologics after the failure of the first anti-TNF agent in patients with Crohn’s disease (CD). The aim of the study was to compare the efficacy of biologics ...
Show more >Background No study has performed a face-to-face comparison of biologics after the failure of the first anti-TNF agent in patients with Crohn’s disease (CD). The aim of the study was to compare the efficacy of biologics in this setting. Methods Patients with CD who were refractory to a first anti-TNF agent, and treated with ustekinumab (UST), vedolizumab (VDZ), or a second anti-TNF drug as a second-line biological agent at 10 French tertiary centres from 2013 to 2019 were retrospectively included in this study. Results Among the 203 patients included, 90 (44%) received UST, 42 (21%) received VDZ and 71 (35%) received a second anti-TNF agent. The first anti-TNF agent was discontinued due to a primary nonresponse in 42 (21%) patients. At weeks 14–24, the rates of steroid-free remission were similar between the UST, VDZ and second anti-TNF groups (29%, 38% and 44%, respectively, p = 0.15). With a mean follow-up of 118 weeks, drug survival was shorter for patients who received ustekinumab treatment (p = 0.001). In the case of trough level less than 5 µg/ml, patients treated with a second anti-TNF agent had a higher postinduction remission rate (p = 0.002), and drug survival (p = 0.0005). No other relevant factors were associated with treatment efficacy, including trough levels greater than 5 µg/ml. Conclusions VDZ, UST and a second anti-TNF agent exhibit similar efficacy in the short term, as second-biological line treatment in patients with CD who are refractory to a first anti-TNF agent, but shorter drug maintenance is observed for patients treated with UST.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

Université de Lille
Inserm
CHU Lille

Collections :

• Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286

Submission date :

2024-01-11T23:58:01Z
2024-02-28T10:46:42Z