Experience With Anti-TNF-α Biologic Agents in Succession in Patients With Crohn’s Disease

Ferges, William; Rampertab, S. Devi; Shafqet, Muhammad A.; Salimi, Qasim; You, Geoffrey; Yousefzadeh, Eleazer; Cheng, Jerry; Das, Kiron M.

doi:10.1097/mcg.0000000000000338

Cited by 8 publications

(10 citation statements)

References 17 publications

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“…In Crohn's disease, few retrospective studies were conducted in that setting, including a limited number of patients. In case of primary nonresponse to adalimumab, a more than 50% chance of response to IFX was observed 30‐32 …”

Section: Discussionmentioning

confidence: 99%

Comparative efficacy and safety of vedolizumab and infliximab in ulcerative colitis after failure of a first subcutaneous anti‐TNF agent: a multicentre cohort study

Hupé¹,

Rivière²,

Nancey³

et al. 2020

Aliment Pharmacol Ther

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Background: Few data exist to help select a second biologic agent in patients with refractory ulcerative colitis (UC). Aim:To compare the efficacy of infliximab (IFX) and vedolizumab (VDZ) in UC patients who failed a first subcutaneous anti-tumor necrosing factor (TNF) agent.Methods: Consecutive UC patients from 12 French centres starting IFX or VDZ after at least one injection of adalimumab or golimumab have been included in a retrospective study. Outcomes were clinical remission at week 14, survival without treatment discontinuation and survival without UC-related event.Results: Among the 225 patients included, clinical remission at week 14 was achieved in 40/154 (26%) patients treated with IFX and in 35/71 (49%) treated with VDZ (P = 0.001). After a propensity score matching analysis, this difference remained significant (odds ratio: 1.67; 95% confidence interval: 1.08-2.56; P = 0.02). With a median follow-up of 117 weeks, survival rates without treatment discontinuation at years 1 and 3 were 50% and 29% with IFX, and 80% and 55% with VDZ, respectively (P < 0.001). Regarding survival without UC-related event, they were 49% and 27% with IFX, and 74% and 52% with VDZ (P < 0.01). Conclusion:After failure of a first subcutaneous anti-TNF agent, UC patients were more likely to achieve clinical remission with VDZ than those treated with IFX.Although due to prescription habits patients in the IFX group had a significantly more severe disease, these differences remained after adjustments and subgroup analyses. Such results have to be confirmed prospectively and warrant dedicated head-to-head trials. | 853HUPÉ et al.

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Section: Discussionmentioning

confidence: 99%

Comparative efficacy and safety of vedolizumab and infliximab in ulcerative colitis after failure of a first subcutaneous anti‐TNF agent: a multicentre cohort study

Hupé¹,

Rivière²,

Nancey³

et al. 2020

Aliment Pharmacol Ther

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“…Remission rates are higher when the first anti-TNF treatment is withdrawn owing to intolerance rather than after primary or secondary failure. [20][21][22] Refractory RA patients are commonly managed by switching from one anti-TNF drug to another, despite first-line therapies often yielding better results than the second-line therapies. [23][24][25] Patients with psoriasis benefit from switching to a second TNF antagonist after the failure of the first, even though response rates to the second anti-TNF-based therapy are lower than the first.…”

Section: Limitations Of Parenteral Administration Of Anti-tnf Agentsmentioning

confidence: 99%

“…High CD‐induced remission rates (43%) were also shown for different anti‐TNF treatments after the initial failure of infliximab. Remission rates are higher when the first anti‐TNF treatment is withdrawn owing to intolerance rather than after primary or secondary failure . Refractory RA patients are commonly managed by switching from one anti‐TNF drug to another, despite first‐line therapies often yielding better results than the second‐line therapies .…”

Section: Introductionmentioning

confidence: 99%

Immune rebalancing by oral immunotherapy: A novel method for getting the immune system back on track

Ilan

2018

Journal of Leukocyte Biology

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Immune modulating treatments are often associated with immune suppression or an opposing anti‐inflammatory paradigm. As such, there is a risk of exposing patients to infections and malignancies. Contrarily, eliciting only mild immune modulation can be insufficient for alleviating immune‐mediated damage. Oral immunotherapy is a novel approach that uses the inherent ability of the gut immune system to generate signals that specifically suppress inflammation at affected sites, without inducing generalized immune suppression. Oral immunotherapy is being developed as a method to rebalance systemic immunity and restore balance, getting it back on track, rather than pushing the immune response too much or too little in opposing directions. Here, I review recent preclinical and clinical data examining the technique and describe its primary advantages.

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“…Previous comparisons of first‐line anti‐TNF agents may have been influenced by channelling bias, that is drugs with similar therapeutic indications are used differently in patient groups with prognostic differences 5,7‐12 . Besides this, the generalisability of most previous observational studies may be questioned since most studies involved patients treated at tertiary referral centers 6,14‐17 …”

Section: Introductionmentioning

confidence: 99%

Predictors of drug survival: A cohort study comparing anti‐tumour necrosis factor agents using the Swedish inflammatory bowel disease quality register

Visuri¹,

Eriksson²,

Olén³

et al. 2021

Aliment Pharmacol Ther

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Summary Background Whether long‐term effectiveness differs between anti‐tumour necrosis factor (anti‐TNF) agents is unknown. Aims To examine drug survival of first‐line anti‐TNF agents and identify predictors of discontinuation. To reduce channelling bias, we also compared drug survival of the second anti‐TNF. Methods Biologic‐naïve patients (N = 955) recorded in the Swedish IBD Quality Register (SWIBREG) were examined. We used propensity score matching, comparing drug survival over up to three years of follow‐up. Cox regression estimated adjusted hazard ratios (aHRs) with 95% confidence intervals (CIs). Results In Crohn's disease, discontinuation because of lack/loss of response was 32% [95%CI = 26%‐38%] for infliximab versus 16% [95%CI = 11%‐21%] for adalimumab. Infliximab [vs adalimumab; aHR = 1.96; 95%CI = 1.20‐3.21] and colonic disease (L2) [vs no L2; aHR = 2.17; 95% CI = 1.26‐3.75] were associated with higher discontinuation rates, whereas normalised CRP at three months [aHR = 0.40; 95% CI = 0.19‒0.81] with a lower rate. Consistently, patients who switched from adalimumab to infliximab (vs infliximab to adalimumab) had earlier discontinuation (P = 0.04). Concomitant use of immunomodulators was associated with a lower adverse drug reaction‐mediated discontinuation rate [aHR = 0.46; 95% CI = 0.28‐0.77], in part explained by fewer infusion reactions [aHR = 0.27; 95% CI = 0.08‐0.89]. In ulcerative colitis, the probability of discontinuation because of lack/loss of response was 40% [95% CI = 33%‐47%] for infliximab versus 37% [95% CI = 21%‐53%] for adalimumab. Disease duration ≥10 years [aHR = 0.25; 95% CI = 0.10‐0.58] and normalised CRP after three months [aHR = 0.39; 95% CI = 0.18‒0.84] were associated with lower discontinuation rates. Conclusions Clinical characterisation of patients may aid decision‐making on anti‐TNF treatment. The consistently shorter drug survival for infliximab (vs adalimumab) in Crohn's disease, suggests a potential difference between the two drugs.

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Experience With Anti-TNF-α Biologic Agents in Succession in Patients With Crohn’s Disease

Cited by 8 publications

References 17 publications

Comparative efficacy and safety of vedolizumab and infliximab in ulcerative colitis after failure of a first subcutaneous anti‐TNF agent: a multicentre cohort study

Comparative efficacy and safety of vedolizumab and infliximab in ulcerative colitis after failure of a first subcutaneous anti‐TNF agent: a multicentre cohort study

Immune rebalancing by oral immunotherapy: A novel method for getting the immune system back on track

Predictors of drug survival: A cohort study comparing anti‐tumour necrosis factor agents using the Swedish inflammatory bowel disease quality register

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