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

Autores de FISABIO

Nuria Jimenez Garcia

Autor
Pedro Almela Notari

Autor

Autores ajenos a FISABIO

Calafat, M
Torres, P
Tosca-Cuquerella, J
Sánchez-Aldehuelo, R
Rivero, M
Iborra, M
González-Vivo, M
Vera, I
de Castro, L
Bujanda, L
Barreiro-de Acosta, M
González-Muñoza, C
Calvet, X
Benítez, JM
Llorente-Barrio, M
Surís, G
Cañete, F
Arias-García, L
Monfort, D
Castaño-García, A
Garcia-Alonso, FJ
Huguet, JM
Marín-Jímenez, I
Lorente, R
Martín-Cardona, A
Ferrer, JA
Camo, P
Gisbert, JP
Pajares, R
Gomollón, F
Castro-Poceiro, J
Morales-Alvarado, J
Llaó, J
Rodríguez, A
Rodríguez, C
Pérez-Galindo, P
Navarro, M
Carrillo-Palau, M
Blázquez-Gómez, I
Sesé, E
de la Piscina, PR
Taxonera, C
Rodríguez-Lago, I
Cabrinety, L
Vela, M
Mínguez, M
Mesonero, F
García, MJ
Aguas, M
Márquez, L
Porto, MS
Pineda, JR
García-Etxebarría, K
Bertoletti, F
Brunet, E
Mañosa, M
Domènech, E
ENEIDA-GETECCU Investigators

Grupos de Investigación

GRUPO 052. GRUPO DE INVESTIGACIÓN EN PATOLOGÍA DIGESTIVA DEL HOSPITAL GENERAL UNIVERSITARIO DE CASTELLÓN

Investigador/a Principal

Pedro Almela Notari

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 registryBackground: 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.