Abstract

Treatment patterns and intensification within 5 year of follow-up of the first-line anti-TNFa used for the treatment of IBD: Results from the VERNE study

Dig Liver Dis. 2021 Jul 6;S1590-8658(21)00319-4. doi: 10.1016/j.dld.2021.06.005.Online ahead of print.

G Bastida 1I Marín-Jiménez 2A Forés 3E García-Planella 4F Argüelles-Arias 5I Tagarro 6A Fernandez-Nistal 6C Montoto 6J Aparicio 6M Aguas 7J Santos-Fernández 8M M Boscá-Watts 9R Ferreiro-Iglesias 10O Merino 11X Aldeguer 12X Cortés 13B Sicilia 14F Mesonero 15M Barreiro-de Acosta 10

 

 
     

Author information

  • 1Department of Gastroenterology, Hospital La Fe, Valencia, Spain. Electronic address: guille.bastida@gmail.com.
  • 2Department of Gastroenterology, Hospital Gregorio Marañón and Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.
  • 3Hospital General Universitario de Castellón, Castellón, Spain.
  • 4Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
  • 5Hospital Universitario Virgen Macarena, Sevilla, Spain.
  • 6Takeda Farmacéutica España S.A., Madrid, Spain.
  • 7Department of Gastroenterology, Hospital La Fe, Valencia, Spain.
  • 8Department of Gastroenterology, Hospital Universitario Río Hortega, Valladolid, Spain.
  • 9IBD Unit, Gastroenterology Department of the University Clinic Hospital of Valencia, Valencia, Spain.
  • 10Department of Gastroenterology, Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain.
  • 11Department of Gastroenterology, Hospital Universitario Cruces, Bilbao, Spain.
  • 12Department of Gastroenterology, Hospital Dr Josep Trueta, Girona, Spain.
  • 13IBD Unit, Gastroenterology Section, Internal Medicine Hospital of Sagunto, Sagunto, Spain; University of Cardenal Herrera-CEU, Castellón, Spain.
  • 14Hospital Universitario de Burgos, Burgos, Spain.
  • 15Gastroenterology Department, Hospital Ramón y Cajal, Madrid, Spain.

Abstract

Background: Anti-TNFα represent one of the main treatment approaches for the management of inflammatory bowel diseases (IBD). Therefore,the evaluation of their treatment patterns over time provides valuable insights about the clinical value of therapies and associated costs.

Aims: To assess the treatment patterns with the first anti-TNFα in IBD.

Methods: Retrospective, observational study.

Results: 310 IBD patients were analyzed along a 5-year follow-up period. 56.2% of Crohn's disease (CD) patients started with adalimumab (ADA), while 43.8% started with infliximab (IFX). 12.9% of ulcerative colitis (UC) patients initiated with ADA, while 87.1% initiated with IFX. Treatment intensification was required in 28.9% of CD and 37.1% of UC patients. Median time to treatment intensification was shorter in UC than in CD (5.3 vs. 14.3 months; p = 0.028). Treatment discontinuation due to reasons other than remission were observed in 40.7% of CD and 40.5% of UC patients, although, in UC patients there was a trend to lower discontinuation rates with IFX (36.6%) than with ADA (66.7%). Loss of response accounted for approximately one-third of discontinuations, in both CD and UC.

Conclusions: Around one-third of IBD biologic-naive patients treated with an anti-TNFα required treatment intensification (earlier in UC) and around 40% discontinued the anti-TNFα due to inappropriate disease control.

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