The effectiveness of ustekinumab and vedolizumab as third-line biologic therapy in patients with Crohn's disease.
Biologics
Effectiveness
Positioning
Real-world
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:
04 2023
04 2023
Historique:
received:
21
06
2022
revised:
04
08
2022
accepted:
16
08
2022
medline:
28
3
2023
pubmed:
21
9
2022
entrez:
20
9
2022
Statut:
ppublish
Résumé
The effectiveness of Ustekinumab (UST) and Vedolizumab (VDZ) in patients with Crohn's disease (CD) as third-line biologic therapies is unclear. We performed a multicentre, real-world assessment of the effectiveness of UST and VDZ among highly-refractory patients with CD. Data of consecutive patients with CD treated with UST and VDZ as third-line biologic therapy until December 2021 were extracted from the cohort of the Sicilian Network for Inflammatory Bowel Disease (SN-IBD). 143 patients (UST: n = 113; VDZ: n = 30) were included. At the end of induction, the rates of clinical response (CR) were 61.9% for UST and 60.0% for VDZ (p = 1.00), with steroid-free clinical remission (SFCR) achieved in 38.1% of patients in the UST group and 43.3% of patients in the VDZ group (p = 0.75). After 52 weeks of observation, the rates of CR were 65.9% for UST and 71.4% for VDZ (p = 0.77), while the rates of SFCR were 51.8% for UST and 57.1% for VDZ (p = 0.78). At multiple Cox proportional hazard regression model, age (HR 0.98; p = 0.04) and need for systemic steroids at baseline (HR 3.29; p = 0.003) were found to be independent predictors of treatment discontinuation. Both VDZ and UST showed high effectiveness as third-line biologic therapy in CD, without significant differences between them.
Sections du résumé
BACKGROUND
The effectiveness of Ustekinumab (UST) and Vedolizumab (VDZ) in patients with Crohn's disease (CD) as third-line biologic therapies is unclear.
AIMS
We performed a multicentre, real-world assessment of the effectiveness of UST and VDZ among highly-refractory patients with CD.
METHODS
Data of consecutive patients with CD treated with UST and VDZ as third-line biologic therapy until December 2021 were extracted from the cohort of the Sicilian Network for Inflammatory Bowel Disease (SN-IBD).
RESULTS
143 patients (UST: n = 113; VDZ: n = 30) were included. At the end of induction, the rates of clinical response (CR) were 61.9% for UST and 60.0% for VDZ (p = 1.00), with steroid-free clinical remission (SFCR) achieved in 38.1% of patients in the UST group and 43.3% of patients in the VDZ group (p = 0.75). After 52 weeks of observation, the rates of CR were 65.9% for UST and 71.4% for VDZ (p = 0.77), while the rates of SFCR were 51.8% for UST and 57.1% for VDZ (p = 0.78). At multiple Cox proportional hazard regression model, age (HR 0.98; p = 0.04) and need for systemic steroids at baseline (HR 3.29; p = 0.003) were found to be independent predictors of treatment discontinuation.
CONCLUSIONS
Both VDZ and UST showed high effectiveness as third-line biologic therapy in CD, without significant differences between them.
Identifiants
pubmed: 36127230
pii: S1590-8658(22)00653-3
doi: 10.1016/j.dld.2022.08.028
pii:
doi:
Substances chimiques
Ustekinumab
FU77B4U5Z0
vedolizumab
9RV78Q2002
Gastrointestinal Agents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
471-477Informations de copyright
Copyright © 2022. Published by Elsevier Ltd.