Outcome in ulcerative colitis after switch from adalimumab/golimumab to infliximab: A multicenter retrospective study

Viola A1, Pugliese D2, Renna S3, Furfaro F4, Caprioli F5, D'Incà R6, Bossa F7, Mazza S5, Costantino G1, Fantini M8, Fiorino G4, Alibrandi A9, Orlando A3, Armuzzi A2, Fries W10. Dig Liver Dis. 2018 Oct 28. pii: S1590-8658(18)31207-6. doi: 10.1016/j.dld.2018.10.013. [Epub ahead of print]

Author information

1 Clinical Unit for Chronic Bowel Disorders, Dept. of Clinical and Experimental Medicine, University of Messina, Messina, Italy.

2 IBD-Unit Complesso Integrato Columbus, Fondazione Policlinico Gemelli, Catholic University, Rome, Italy.

3 IBD-Unit, Division of Internal Medicine, "Villa Sofia-Cervello" Hospital, Palermo, Italy.

4 Humanitas Research Hospital, Rozzano, IBD Center, Department of Gastroenterology, Milan, Italy.

5 Gastroenterology and Endoscopy Unit, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.

6 Gastroenterology Unit, Department of Surgical, Oncological, and Gastroenterological Sciences, University of Padua, Padua, Italy.

7 Div. of Gastroenterology, IRCCS "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Foggia, Italy.

8 Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy.

9 Dept. of Economics, University of Messina, Messina, Italy.

10 Clinical Unit for Chronic Bowel Disorders, Dept. of Clinical and Experimental Medicine, University of Messina, Messina, Italy. Electronic address: fwalter@unime.it.


BACKGROUND: Anti-TNF therapies infliximab (IFX), adalimumab (ADA), and golimumab (GOL) are approved for treating moderate to severe ulcerative colitis (UC). In UC, only the switch from IFX to ADA has been investigated, reaching no more than 10-43% remission rates at 12 months.

AIM: Of the present study was to investigate disease outcome after a switch from subcutaneous (SC) agents to the intravenous (IV) agent (IFX).

METHODS: In this retrospective multicentre study, we analysed the charts of UC patients unresponsive/intolerant or with secondary loss of response (LOR) to ADA or GOL who were switched to IFX. We evaluated clinical response and remission together with adverse events at 3, 6, and 12 months follow-up.

RESULTS: Seventy-six patients were included; 38 patients started ADA and 38 started GOL for a mean therapy duration of 6 ± 6 months. Indications for switch were adverse events in 3%, primary failure in 79%, and LOR in 18% of patients. Clinical remission was reached by 47%, 50%, and 77% of patients, respectively. Patients that switched for LOR did numerically, but not statistically, better than patients who switched for primary failure.

CONCLUSIONS: Our data show a superior remission rate in SC to IV anti-TNF switch in UC compared to the IV to SC switch reported in literature.

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