Dose escalation and switching of biologics in ulcerative colitis: a systematic literature review in real-world evidence.
Curr Med Res Opin
; 35(11): 1911-1923, 2019 11.
Article
em En
| MEDLINE
| ID: mdl-31192706
ABSTRACT
Background:
Biologics used to treat ulcerative colitis (UC) may lose their effect over time, requiring patients to undergo dose escalation or treatment switching, and systematic literature reviews of real-world evidence on these topics are lacking.Aim:
To summarize the occurrence and outcomes of dose escalation and treatment switching in UC patients in real-world evidence.Methods:
Studies were searched through MEDLINE, MEDLINE IN PROCESS, Embase and Cochrane (2006-2017) as well as proceedings from three major scientific meetings.Results:
In total, 41 studies were included in the review among which 35 covered dose escalation and 12 covered treatment switching of biologics. Tumor necrosis factor antagonist (anti-TNF) escalation for all patients included at induction ranged from 5% (6 months) to 50% (median 0.67 years) and 15.2% to 70.8% (8 weeks) for anti-TNF induction responders. Mean/median time to dose escalation on anti-TNF ranged from 1.84 to 11 months. The most common switching pattern, infliximab â adalimumab, occurred in 3.8% (median 5.6 years) to 25.5% (mean 3.3 years) of patients.Conclusions:
Dose escalation and treatment switching of biologics may be considered as indicators of suboptimal therapy suggesting a lack of long-term remission and response under current therapies.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Colite Ulcerativa
/
Fator de Necrose Tumoral alfa
/
Adalimumab
/
Infliximab
Tipo de estudo:
Systematic_reviews
Limite:
Humans
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article