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https://hdl.handle.net/2445/173702
Title: | Effectiveness and Safety of the Sequential Use of a Second and Third Anti-TNF Agent in Patients With Inflammatory Bowel Disease: Results From the Eneida Registry |
Author: | Casanova, María José Chaparro, María Mínguez, Miguel Ricart, Elena Taxonera, Carlos García López, Santiago Guardiola, Jordi López San Román, Antonio Iglesias, Eva Beltrán, Belén Sicilia, Beatriz Vera, María Isabel Hinojosa, Joaquín Riestra, Sabino Domènech, Eugeni Calvet, Xavier Pérez Calle, José Lázaro Martín Arranz, María Dolores Aldeguer, Xavier Rivero, Montserrat Monfort, David Barrio, Jesús Esteve i Comas, Maria Márquez, Lucía Lorente, Rufo García Planella, Esther Castro, Luisa de Bermejo, Fernando Merino, Olga Rodríguez Pérez, Antonio Martínez Montiel, Pilar Van Domselaar, Manuel Alcaín, Guillermo Domínguez Cajal, Manuel Muñoz, Carmen Gomollón, Fernando Fernández Salazar, Luis García Sepulcre, Mariana Fe Rodríguez Lago, Iago Gutiérrez, Ana Argüelles Arias, Federico Rodríguez, Cristina Rodríguez, Gloria Esther Bujanda, Luis Llaó, Jordina Varela, Pilar Ramos, Laura Huguet, José María Almela, Pedro Romero, Patricia Navarro Llavat, Mercè Abad, Águeda Ramírez de la Piscina, Patricia Lucendo, Alfredo J. Sesé, Eva Madrigal, Rosa Eva Charro, Mara García Herola, Antonio Pajares, Ramón Khorrami, Sam Gisbert, Javier P. |
Keywords: | Malalties inflamatòries intestinals Necrosi Inflammatory bowel diseases Necrosis |
Issue Date: | 29-Aug-2019 |
Publisher: | Wiley-Blackwell |
Abstract: | Background: The effectiveness of the switch to another anti-tumor necrosis factor (anti-TNF) agent is not known. The aim of this study was to analyze the effectiveness and safety of treatment with a second and third anti-TNF drug after intolerance to or failure of a previous anti-TNF agent in inflammatory bowel disease (IBD) patients. Methods: We included patients diagnosed with IBD from the ENEIDA registry who received another anti-TNF after intolerance to or failure of a prior anti-TNF agent. Results: A total of 1122 patients were included. In the short term, remission was achieved in 55% of the patients with the second anti-TNF. The incidence of loss of response was 19% per patient-year with the second anti-TNF. Combination therapy (hazard ratio [HR], 2.4; 95% confidence interval [CI], 1.8-3; P < 0.0001) and ulcerative colitis vs Crohn's disease (HR, 1.6; 95% CI, 1.1-2.1; P = 0.005) were associated with a higher probability of loss of response. Fifteen percent of the patients had adverse events, and 10% had to discontinue the second anti-TNF. Of the 71 patients who received a third anti-TNF, 55% achieved remission. The incidence of loss of response was 22% per patient-year with a third anti-TNF. Adverse events occurred in 7 patients (11%), but only 1 stopped the drug. Conclusions: Approximately half of the patients who received a second anti-TNF achieved remission; nevertheless, a significant proportion of them subsequently lost response. Combination therapy and type of IBD were associated with loss of response. Remission was achieved in almost 50% of patients who received a third anti-TNF; nevertheless, a significant proportion of them subsequently lost response. |
Note: | Versió postprint del document publicat a: https://doi.org/10.1093/ibd/izz192 |
It is part of: | Inflammatory Bowel Diseases, 2019, vol. 26, num. 4, p. 606-616 |
URI: | https://hdl.handle.net/2445/173702 |
Related resource: | https://doi.org/10.1093/ibd/izz192 |
ISSN: | 1078-0998 |
Appears in Collections: | Articles publicats en revistes (Medicina) Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer) Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL)) |
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