连续使用两种抗肿瘤坏死因子药物治疗的溃疡性结肠炎患者第二次皮下或静脉注射抗肿瘤坏死因子的临床和治疗效果:ENEIDA 登记数据。

IF 3.9 3区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Therapeutic Advances in Gastroenterology Pub Date : 2024-01-05 eCollection Date: 2024-01-01 DOI:10.1177/17562848231221713
Margalida Calafat, Paola Torres, Joan Tosca-Cuquerella, Rubén Sánchez-Aldehuelo, Montserrat Rivero, Marisa Iborra, María González-Vivo, Isabel Vera, Luisa de Castro, Luis Bujanda, Manuel Barreiro-de Acosta, Carlos González-Muñoza, Xavier Calvet, José Manuel Benítez, Mónica Llorente-Barrio, Gerard Surís, Fiorella Cañete, Lara Arias-García, David Monfort, Andrés Castaño-García, Francisco Javier Garcia-Alonso, José M Huguet, Ignacio Marín-Jímenez, Rufo Lorente, Albert Martín-Cardona, Juan Ángel Ferrer, Patricia Camo, Javier P Gisbert, Ramón Pajares, Fernando Gomollón, Jesús Castro-Poceiro, Jair Morales-Alvarado, Jordina Llaó, Andrés Rodríguez, Cristina Rodríguez, Pablo Pérez-Galindo, Mercè Navarro, Nuria Jiménez-García, Marta Carrillo-Palau, Isabel Blázquez-Gómez, Eva Sesé, Pedro Almela, Patricia Ramírez de la Piscina, Carlos Taxonera, Iago Rodríguez-Lago, Lidia Cabrinety, Milagros Vela, Miguel Mínguez, Francisco Mesonero, María José García, Mariam Aguas, Lucía Márquez, Marisol Silva Porto, Juan R Pineda, Koldo García-Etxebarría, Federico Bertoletti, Eduard Brunet, Míriam Mañosa, Eugeni Domènech
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引用次数: 0

摘要

背景:英夫利西单抗似乎是目前治疗溃疡性结肠炎(UC)的三种抗肿瘤坏死因子药物中疗效最好的一种,但人们对其作为第二种抗肿瘤坏死因子药物的使用情况知之甚少:比较皮下注射或静脉注射第二种抗肿瘤坏死因子对 UC 患者的临床和治疗效果:设计:回顾性观察研究:方法:对ENEIDA登记处连续接受英夫利西单抗和皮下注射抗肿瘤坏死因子(或相反)治疗的患者进行鉴定,并根据第一种抗肿瘤坏死因子的给药途径分为IVi(静脉注射初始)或SCi(皮下注射初始):总共纳入了 473 例 UC 患者(330 例 IVi 和 143 例 SCi)。第14周时,静脉注射组和皮下注射组的临床应答率分别为42.7%和48.3%(无统计学意义)。第52周时,IVi组和SCi组的临床缓解率分别为32.8%和31.4%(差异不显著)。倾向匹配评分分析显示,SCi 组第 14 周的临床应答率更高,IVi 组的治疗持续率更高。在长期结果方面,第一种抗肿瘤坏死因子治疗失败导致的剂量升级和停药以及第二种抗肿瘤坏死因子治疗开始时更严重的疾病活动与临床缓解成反比:结论:就疗效而言,使用第二种抗肿瘤坏死因子治疗 UC 似乎是合理的,但在第一种抗肿瘤坏死因子初次治疗失败的情况下,疗效尤其会降低。第二种抗肿瘤坏死因子是英夫利西单抗还是皮下注射似乎并不影响疗效。
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Clinical and treatment outcomes of a second subcutaneous or intravenous anti-TNF in patients with ulcerative colitis treated with two consecutive anti-TNF agents: data from the ENEIDA registry.

Background: Infliximab seems to be the most efficacious of the three available anti-TNF agents for ulcerative colitis (UC) but little is known when it is used as the second anti-TNF.

Objectives: To compare the clinical and treatment outcomes of a second subcutaneous or intravenous anti-TNF in UC patients.

Design: Retrospective observational study.

Methods: Patients from the ENEIDA registry treated consecutively with infliximab and a subcutaneous anti-TNF (or vice versa), naïve to other biological agents, were identified and grouped according to the administration route of the first anti-TNF into IVi (intravenous initially) or SCi (subcutaneous initially).

Results: Overall, 473 UC patients were included (330 IVi and 143 SCi). Clinical response at week 14 was 42.7% and 48.3% in the IVi and SCi groups (non-statistically significant), respectively. Clinical remission rates at week 52 were 32.8% and 31.4% in the IVi and SCi groups (nonsignificant differences), respectively. A propensity-matched score analysis showed a higher clinical response rate at week 14 in the SCi group and higher treatment persistence in the IVi group. Regarding long-term outcomes, dose escalation and discontinuation due to the primary failure of the first anti-TNF and more severe disease activity at the beginning of the second anti-TNF were inversely associated with clinical remission.

Conclusion: The use of a second anti-TNF for UC seems to be reasonable in terms of efficacy, although it is particularly reduced in the case of the primary failure of the first anti-TNF. Whether the second anti-TNF is infliximab or subcutaneous does not seem to affect efficacy.

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来源期刊
Therapeutic Advances in Gastroenterology
Therapeutic Advances in Gastroenterology GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
6.70
自引率
2.40%
发文量
103
审稿时长
15 weeks
期刊介绍: Therapeutic Advances in Gastroenterology is an open access journal which delivers the highest quality peer-reviewed original research articles, reviews, and scholarly comment on pioneering efforts and innovative studies in the medical treatment of gastrointestinal and hepatic disorders. The journal has a strong clinical and pharmacological focus and is aimed at an international audience of clinicians and researchers in gastroenterology and related disciplines, providing an online forum for rapid dissemination of recent research and perspectives in this area. The editors welcome original research articles across all areas of gastroenterology and hepatology. The journal publishes original research articles and review articles primarily. Original research manuscripts may include laboratory, animal or human/clinical studies – all phases. Letters to the Editor and Case Reports will also be considered.
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