Therapeutic Advances in Gastroenterology (Jan 2024)

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

  • 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

DOI
https://doi.org/10.1177/17562848231221713
Journal volume & issue
Vol. 17

Abstract

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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.