Letter: choosing between ustekinumab and vedolizumab in anti‐TNF refractory Crohn's disease—the devil is in the detail. Authors' reply

Alric, Hadrien; Amiot, Aurélien; Carbonnel, Franck; Meyer, Antoine

doi:10.1111/apt.15888

Cited by 1 publication

(1 citation statement)

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“…The natural history of utilization of any new drug naturally favors its use in patients who failed previous and better established treatments: thus, early real-world experience (RWE) series with VDZ included few biologic-naïve patients [18,21,26,38], whereas later series addressing biologic-naïve patients demonstrated higher effectiveness in comparison to those early publications [17,39,40]; for UST, data for biologic-naïve patients is still sparse. Similarly, the literature regarding the use of third-class biologics in IBD is limited to small numbers of patients in RWE series of biologic-experienced patients [27,[41][42][43]. To date, the personalization of therapeutic decisions in IBD is underdeveloped, with limited clues to suggest which succession of therapeutic regimens is superior and subsequently likely to work best in patients failing several consecutive biologic treatments.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Third-Class Biologic Treatment in Crohn’s Disease: A Multi-Center Retrospective Cohort Study

Albshesh

Taylor

Savarino

et al. 2021

JCM

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Background: Multiple studies have described the effectiveness of ustekinumab (UST) and vedolizumab (VDZ) in patients with Crohn’s disease (CD) failing anti- Tumor necrosis factors (TNFs); however, the effectiveness of VDZ or UST as a third-class biologic has not yet been described. Aims and Methods: In this retrospective multicenter cohort study, we aimed to investigate the effectiveness of VDZ and UST as a third-class biologic in patients with CD. Results: Two-hundred and four patients were included; 156/204 (76%) patients received VDZ as a second- and UST as a third-class therapy (group A); the remaining 48/204 (24%) patients received UST as a second- and VDZ as a third-class therapy (group B). At week 16–22, 87/156 (55.5%) patients and 27/48 (56.2%) in groups A and B, respectively, responded to treatment (p = 0.9); 41/156 (26.2%) and 15/48 (31.2%) were in clinical remission (p = 0.5). At week 52; 89/103 (86%) patients and 25/29 (86.2%) of the patients with available data had responded to third-class treatment in groups A and B, respectively (p = 0.9); 31/103 (30%) and 47/29 (24.1%) were in clinical remission (p = 0.5). Conclusion: Third-class biological therapy was effective in more than half of the patients with CD. No differences in effectiveness were detected between the use of VDZ and UST as a third-class agent.

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