Title :

Real-world comparison of effectiveness between tofacitinib and vedolizumab in patients with ulcerative colitis exposed to at least one anti-TNF agent.

Author(s) :

Buisson, Anthony [Auteur]
Microbes, Intestin, Inflammation et Susceptibilité de l'Hôte [M2iSH]
Nachury, Maria [Auteur]
Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286
Guilmoteau, Thomas [Auteur]
Infection Inflammation et Interaction Hôtes Pathogènes [CHU Clermont-Ferrand] [3IHP ]
Altwegg, Romain [Auteur]
Hôpital Saint Eloi [CHRU Montpellier]
Treton, Xavier [Auteur]
Hôpital Beaujon [AP-HP]
Fumery, Mathurin [Auteur]
Université de Picardie Jules Verne [UPJV]
Serrero, Melanie [Auteur]
Hôpital Nord [CHU - APHM]
Leclerc, Eloïse [Auteur]
Infection Inflammation et Interaction Hôtes Pathogènes [CHU Clermont-Ferrand] [3IHP ]
Caillo, Ludovic [Auteur]
Centre Hospitalier Universitaire de Nîmes [CHU Nîmes]
Pereira, Bruno [Auteur]
Direction de la recherche clinique et de l’innovation [CHU Clermont-Ferrand] [DRCI]
Amiot, Aurélien [Auteur]
Early detection of Colon Cancer using Molecular Markers and Microbiota (EA 7375) [EC2M3]
Bouguen, Guillaume [Auteur]
Centre d'Investigation Clinique [Rennes] [CIC]

Journal title :

Alimentary Pharmacology and Therapeutics

Abbreviated title :

Aliment Pharmacol Ther

Volume number :

57

Pages :

676-688

Publication date :

2022-11-22

ISSN :

1365-2036

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Background Data comparing tofacitinib and vedolizumab in ulcerative colitis (UC) are lacking. Aims To compare the effectiveness of tofacitinib and vedolizumab in patients with UC who had prior exposure to anti-TNF ...
Show more >Background Data comparing tofacitinib and vedolizumab in ulcerative colitis (UC) are lacking. Aims To compare the effectiveness of tofacitinib and vedolizumab in patients with UC who had prior exposure to anti-TNF therapy Methods In this multicentre study, we included consecutive patients with UC ≥18 years old with partial Mayo score >2 and prior anti-TNF exposure, who started tofacitinib or vedolizumab between January 2019 and June 2021. Comparisons were performed using propensity score analyses (inverse probability of treatment weighting). Results Overall, 126 and 178 patients received tofacitinib and vedolizumab, respectively. Intensified induction (vedolizumab infusion at week 10 or tofacitinib 10 mg b.d until week 16) was performed in 28.5% and 41.5% of patients, respectively. After propensity-score analysis, corticosteroid-free clinical remission (partial Mayo score ≤2) was achieved at week 16 in 45.1% and 40.2% of patients receiving tofacitinib and vedolizumab, respectively (aOR = 0.82 [0.35–1.91], p = 0.64). Endoscopic improvement (corticosteroid-free clinical remission and endoscopic Mayo score ≤1) (aOR = 0.23[0.08–0.65], p = 0.0032) and histological healing (endoscopic improvement + Nancy histological index ≤1) (13.4% vs 3.2%, aOR = 0.21[0.05–0.91], p = 0.023) were higher at week 16 in patients treated with tofacitinib. No factor was predictive of tofacitinib effectiveness. At least one primary failure to a biologic (OR = 0.46[0.22–0.99], p = 0.049), partial Mayo score >6 (OR = 0.39[0.17–0.90], p = 0.029) and CRP level > 30 mg/L at baseline (OR = 0.08[0.01–0.85], p = 0.036) were associated with vedolizumab failure. Conclusion Tofacitinib and vedolizumab are effective in UC after failure of anti-TNF agents. However, tofacitinib seems more effective, especially in severe disease and primary failure to biologics.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 :

2024-01-12T00:02:12Z
2024-02-28T10:24:20Z