Comparison of Short- and Long-Term Effectiveness between Anti-TNF and Ustekinumab after Vedolizumab Failure as First-Line Therapy in Crohn’s Disease: A Multi-Center Retrospective Cohort Study

Ahmad Albshesh*, Lian Bannon, Tali Sharar Fischler, Marie Truyens, Stephan R. Vavricka, Katja Tepes, Daniela Pugliese, Edoardo V. Savarino, Eran Zittan, David Drobne, Xavier Roblin, Ariella Bar-Gil Shitrit, Alessandro Armuzzi, Triana Lobaton, Nitsan Maharshak, Henit Yanai, Shomron Ben-Horin, Uri Kopylov

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The effectiveness of anti-TNF or ustekinumab (UST) as a second-line biologic after vedolizumab (VDZ) failure has not yet been described. Aims and Methods: In this retrospective multicenter cohort study, We aim to investigate the effectiveness of anti-TNF and UST as second-line therapy in patients with Crohn’s disease (CD) who failed VDZ as a first-line treatment. The primary outcome was clinical response at week 16–22. Secondary outcomes included the rates of clinical remission, steroid-free clinical remission, CRP normalization, and adverse events. Results: Fifty-nine patients who failed on VDZ as a first-line treatment for CD were included; 52.8% patients received anti-TNF and 47.2% UST as a second-line therapy. In initial period (Week 16–22), the clinical response and remission rate was similar between both groups: 61.2% vs. 68%, p = 0.8 and 48.3% vs. 56%, p = 0.8 on anti-TNF and UST therapy, respectively. Furthermore, in the maintenance period the rate was similar: 75% vs. 82.3%, p = 0.8 and 62.5% vs. 70.5%, p = 0.8, respectively. Of the patients, 12 out of the 59 stopped the therapy, without a significant difference between the two groups (p = 0.6). Conclusion: Second-line biological therapy after VDZ failure therapy was effective in >60% of the patients with CD. No differences in effectiveness were detected between the use of anti-TNF and UST as a second line.

Original languageEnglish
Article number2503
JournalJournal of Clinical Medicine
Volume12
Issue number7
DOIs
StatePublished - Apr 2023

Keywords

  • Crohn’s disease
  • anti-TNF
  • drug positioning
  • treatment failure
  • treatment response
  • ustekinumab
  • vedolizumab

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