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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
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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.
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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.. 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. _Inflammatory Bowel Diseases_. 2019. Vol. 26, núm. 4, pàgs. 606-616. [consulta: 24 de gener de 2026]. ISSN: 1078-0998. [Disponible a: https://hdl.handle.net/2445/173702]