A propensity score weighted comparison of Vedolizumab, Adalimumab, and Golimumab in patients with ulcerative colitis.
Adalimumab
/ therapeutic use
Adult
Antibodies, Monoclonal
/ therapeutic use
Antibodies, Monoclonal, Humanized
/ therapeutic use
Colitis, Ulcerative
/ drug therapy
Cost-Benefit Analysis
Female
Gastrointestinal Agents
/ therapeutic use
Humans
Logistic Models
Male
Middle Aged
Propensity Score
Retrospective Studies
Severity of Illness Index
Treatment Outcome
Adalimumab
Golimumab
Ulcerative colitis
Vedolizumab
Journal
Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
ISSN: 1878-3562
Titre abrégé: Dig Liver Dis
Pays: Netherlands
ID NLM: 100958385
Informations de publication
Date de publication:
12 2020
12 2020
Historique:
received:
27
02
2020
revised:
03
06
2020
accepted:
05
06
2020
pubmed:
1
7
2020
medline:
2
9
2021
entrez:
1
7
2020
Statut:
ppublish
Résumé
No real-life study on the comparative effectiveness of Vedolizumab (VDZ), Adalimumab (ADA), and Golimumab (GOL) in ulcerative colitis (UC) is currently available. To compare the effectiveness of the three biologics in consecutive patients with UC. A three-arms propensity score-adjusted analysis was performed using the Inverse Probability of Treatment Weighting method. 463 treatments (VDZ: n = 187; ADA: n = 168; GOL: n = 108) were included (median follow-up: 47.6 weeks). At 12 weeks (n = 463), a steroid-free remission was reported in 24.1% patients in the VDZ group, in 33.3% patients in the ADA group, and in 30.6% patients in the GOL group (p = n.s. for all comparisons). At 52 weeks (n = 377), a steroid-free remission was reported in 51.5% patients in the VDZ group, in 31.2% patients in the ADA group, and in 29.4% patients in the GOL group (p = 0.002 for VDZ vs. ADA, p = 0.001 for VDZ vs. GOL, p = n.s. for ADA vs. GOL). Cox survival analysis demonstrated that patients treated with VDZ had reduced probability of treatment discontinuation compared to those treated with ADA (HR: 0.42, 95% CI 0.28-0.64, p < 0.001) and GOL (HR: 0.30, 95% CI 0.19-0.46, p < 0.001), while patients treated with ADA had reduced risk of treatment discontinuation compared to those treated with GOL (HR: 0.71, 95% CI 0.50-1.00, p = 0.048). VDZ was superior to ADA and GOL at 52 weeks and as treatment persistence, while ADA showed a superior treatment persistence compared to GOL.
Sections du résumé
BACKGROUND
No real-life study on the comparative effectiveness of Vedolizumab (VDZ), Adalimumab (ADA), and Golimumab (GOL) in ulcerative colitis (UC) is currently available.
AIMS
To compare the effectiveness of the three biologics in consecutive patients with UC.
METHODS
A three-arms propensity score-adjusted analysis was performed using the Inverse Probability of Treatment Weighting method.
RESULTS
463 treatments (VDZ: n = 187; ADA: n = 168; GOL: n = 108) were included (median follow-up: 47.6 weeks). At 12 weeks (n = 463), a steroid-free remission was reported in 24.1% patients in the VDZ group, in 33.3% patients in the ADA group, and in 30.6% patients in the GOL group (p = n.s. for all comparisons). At 52 weeks (n = 377), a steroid-free remission was reported in 51.5% patients in the VDZ group, in 31.2% patients in the ADA group, and in 29.4% patients in the GOL group (p = 0.002 for VDZ vs. ADA, p = 0.001 for VDZ vs. GOL, p = n.s. for ADA vs. GOL). Cox survival analysis demonstrated that patients treated with VDZ had reduced probability of treatment discontinuation compared to those treated with ADA (HR: 0.42, 95% CI 0.28-0.64, p < 0.001) and GOL (HR: 0.30, 95% CI 0.19-0.46, p < 0.001), while patients treated with ADA had reduced risk of treatment discontinuation compared to those treated with GOL (HR: 0.71, 95% CI 0.50-1.00, p = 0.048).
CONCLUSIONS
VDZ was superior to ADA and GOL at 52 weeks and as treatment persistence, while ADA showed a superior treatment persistence compared to GOL.
Identifiants
pubmed: 32601033
pii: S1590-8658(20)30298-X
doi: 10.1016/j.dld.2020.06.014
pii:
doi:
Substances chimiques
Antibodies, Monoclonal
0
Antibodies, Monoclonal, Humanized
0
Gastrointestinal Agents
0
golimumab
91X1KLU43E
vedolizumab
9RV78Q2002
Adalimumab
FYS6T7F842
Types de publication
Comparative Study
Journal Article
Multicenter Study
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
1461-1466Informations de copyright
Copyright © 2020 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest Fabio Salvatore Macaluso served as an advisory board member and/or received lecture grants from AbbVie, Biogen, MSD, and Takeda Pharmaceuticals. Maria Cappello served as an advisory board member for AbbVie, MSD, Takeda Pharmaceuticals, and received lecture grants from AbbVie, MSD, Chiesi, and Takeda Pharmaceuticals. Filippo Mocciaro served as an advisory board member for AbbVie and MSD Pharmaceuticals, and received lecture grants from AbbVie, MSD and Takeda Pharmaceuticals. Sara Renna served as an advisory board member for AbbVie and MSD Pharmaceuticals, and received lecture grants from AbbVie, MSD and Takeda Pharmaceuticals Ambrogio Orlando served as an advisory board member for AbbVie, MSD, Janssen, Pfizer, Takeda Pharmaceuticals, and received lecture grants from AbbVie, MSD, Sofar, Chiesi, Janssen, Pfizer, and Takeda Pharmaceuticals.