Durability of the First Biologic in Children and Adults With Ulcerative Colitis: A Nationwide Study from the epi-IIRN.
Inflamm Bowel Dis
; 2024 Apr 05.
Article
in En
| MEDLINE
| ID: mdl-38578929
ABSTRACT
BACKGROUND:
In this nationwide study, our objective was to compare the durability of first-line biologics in ulcerative colitis (UC), categorized into monotherapy and combotherapy with immunomodulators.METHODS:
We utilized data from the nationwide epi-IIRN cohort from 2005 to 2020. Durability was defined as consistent treatment without surgery. Comparisons were based on stringent propensity score-matching.RESULTS:
We included 15â 111 patients with UC, of whom 2322 (15%) received biologics, with a median follow-up of 7.0 years (interquartile range, 3.8-11.0). The durability rate was similar between pediatric-onset and adults after 1 and 5 years from initiation of treatment (72% and 43% vs 71% and 43%, respectively; Pâ =â .8). Durability of adalimumab vs infliximab after 1 or 5 years was similar, whether prescribed as monotherapy (65%/46% vs 63%/33%, respectively; nâ =â 182 matched pairs, Pâ =â .3) or combotherapy (78%/56% vs 91%/58%, respectively; nâ =â 46 matched pairs, Pâ =â .4). Durability of infliximab was higher as combotherapy (85%/50%) vs monotherapy (69%/42%; nâ =â 174 matched pairs, Pâ =â .007), while it was similar for adalimumab (80%/52% vs 74%/52%; nâ =â 53 matched pairs, Pâ =â .4). The durability rate was similar for vedolizumab monotherapy (77%/56%) compared with adalimumab monotherapy (69%/52%; nâ =â 125 matched patients, Pâ =â .1), and infliximab monotherapy (73%/55% vs 62%/44%; nâ =â 78 matched patients, Pâ =â .1). However, combotherapy of antitumor necrosis factors (TNFs) had longer durability than vedolizumab (85%/50% vs 75%/43%, respectively; nâ =â 131 matched pairs, Pâ =â .02).CONCLUSION:
After 5 years of treatment, 43% of the patients with UC sustained their first biologic, with similar durability in pediatric and adult-onset onset disease. Anti-TNFs had similar durability to vedolizumab and superior durability when prescribed as combotherapy.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Language:
En
Journal:
Inflamm Bowel Dis
Journal subject:
GASTROENTEROLOGIA
Year:
2024
Document type:
Article
Country of publication:
United kingdom