Comparative Study of the Effectiveness of Vedolizumab Versus Ustekinumab After Anti-TNF Failure in Crohn's Disease (Versus-CD): Data from the ENEIDA Registry

被引：5

作者：

Jose Garcia, Maria ^{[1
]}

Rivero, Montserrat ^{[1
]}

Fernandez-Clotet, Agnes ^{[2
]}

de Francisco, Ruth ^{[3
]}

Sicilia, Beatriz ^{[4
]}

Mesonero, Francisco ^{[5
]}

Luisa de Castro, Maria ^{[6
]}

Jose Casanova, Maria ^{[7
]}

Bertoletti, Federico ^{[8
]}

Javier Garcia-Alonso, Francisco ^{[9
]}

Lopez-Garcia, Alicia ^{[10
]}

Vicente, Raquel ^{[11
]}

Calvet, Xavier ^{[12
]}

Barreiro-de Acosta, Manuel ^{[13
]}

Ferrer Rosique, Juan ^{[14
]}

Varela Trastoy, Pilar ^{[15
]}

Nunez, Alejandro ^{[16
]}

Ricart, Elena ^{[2
]}

Riestra, Sabino ^{[3
]}

Arias Garcia, Lara ^{[4
]}

Rodriguez, Maria ^{[17
]}

Arranz, Laura ^{[18
]}

Pajares, Ramon ^{[19
]}

Mena, Raquel ^{[20
]}

Calafat, Margalida ^{[21
]}

Camo, Patricia ^{[22
]}

Bermejo, Fernando ^{[23
]}

Ponferrada, Angel ^{[24
]}

Eva Madrigal, Rosa ^{[25
]}

Llao, Jordina ^{[26
]}

Sese, Eva ^{[27
]}

Sanchez, Eugenia ^{[5
]}

Pineda Marino, Juan Ramon ^{[6
]}

Gonzalez Munoza, Carlos ^{[8
]}

Carbajo Lopez, Ana Yaiza ^{[9
]}

Belen Julian, Ana ^{[11
]}

Villoria Ferrer, Albert ^{[12
]}

Baston-Rey, Iria ^{[13
]}

Jara, Lorena ^{[14
]}

Almela, Pedro ^{[28
]}

Codesido, Laura ^{[29
]}

de la Maza, Saioa ^{[30
]}

Leal, Carles ^{[31
]}

Caballol, Berta ^{[2
]}

Perez-Martinez, Isabel ^{[3
]}

Vinuesa Campo, Raquel ^{[4
]}

Crespo, Javier ^{[1
]}

Domenech, Eugeni

Chaparro, Maria ^{[7
]}

Gisbert, Javier P. ^{[7
]}

机构：

[1] Univ Cantabria, Hosp Univ Marques de Valdecilla, Inst Invest Valdecilla IDIVAL, Gastroenterol & Hepatol Dept, Santander, Spain

[2] Hosp Clin Barcelona, Ctr Invest Biomed Red Enfermedades Hepat & Digest, Inst Invest Biomed August Pi & Sunyer IDIBAPS, Inflammatory Bowel Dis Unit,Gastroenterol Dept, Barcelona, Spain

[3] Hosp Univ Cent Asturias, Inst Invest Sanitaria Principado Asturias ISPA, Gastroenterol Dept, Oviedo, Spain

[4] Hosp Univ Burgos, Dept Gastroenterol, IBD Unit, Burgos, Spain

[5] Hosp Univ Ramon & Cajal, Gastroenterol Dept, Madrid, Spain

[6] Hosp Alvaro Cunqueiro, Gastroenterol Dept, Vigo, Spain

[7] Univ Autonoma Madrid UAM, Ctr Invest Biomed Red Enfermedades Hepat & Digest, Hosp Univ La Princesa, Inst Invest Sanitaria Princesa IIS Princesa,Gastr, Madrid, Spain

[8] Hosp Santa Creu & Sant Pau, Gastroenterol Dept, Barcelona, Spain

[9] Hosp Univ Rio Hortega, Gastroenterol Dept, Valladolid, Spain

[10] Hosp Mar, Gastroenterol Dept, Barcelona, Spain

[11] Hosp Univ Miguel Servet, Ctr Invest Biomed Red Enfermedades Hepat & Digest, Gastroenterol Dept, Zaragoza, Spain

[12] Ctr Invest Biomed Red Enfermedades Hepat & Digest, Consorci Corp Sanitaria Parc Tauli, Gastroenterol Dept, Sabadell, Spain

[13] Hosp Univ Clin Santiago, Gastroenterol Dept, Santiago De Compostela, Spain

[14] Hosp Univ Fdn Alcorcon, Gastroenterol Dept, Alcorcon, Spain

[15] Hosp Univ Cabuenes, Gastroenterol Dept, Gijon, Spain

[16] Hosp Univ Salamanca, Gastroenterol Dept, Salamanca, Spain

[17] Hosp Gen Univ Ciudad Real, Gastroenterol Dept, Ciudad Real, Spain

[18] Hosp Univ Nuestra Senora Candelaria, Gastroenterol Dept, Tenerife, Spain

[19] Hosp Univ Infanta Sofia, Gastroenterol Dept, Madrid, Spain

[20] Consorci Sanitari Terrasa, Gastroenterol Dept, Barcelona, Spain

[21] Hosp Badalona Germans Trias & Pujol, Ctr Invest Biomed Red Enfermedades Hepat & Digest, Gastroenterol Dept, Badalona, Spain

[22] Hosp Gen San Jorge, Gastroenterol Dept, Huesca, Spain

[23] Hosp Univ Fuenlabrada, Gastroenterol Dept, Madrid, Spain

[24] Hosp Univ Infanta Leonor, Gastroenterol Dept, Madrid, Spain

[25] Hosp Clin Univ Valladolid, Gastroenterol Dept, Valladolid, Spain

[26] Althaia Xarxa Assistencial Univ Manresa, Gastroenterol Dept, Manresa, Spain

[27] Hosp Univ Arnau de Vilanova Lleida, Gastroenterol Dept, Lleida, Spain

[28] Hosp Gen Univ Castellon, Gastroenterol Dept, Castellon de La Plana, Spain

[29] Complexo Hosp Univ Ourense, Gastroenterol Dept, Orense, Spain

[30] Hosp Univ Basurto, Gastroenterol Dept, Bilbao, Spain

[31] Consorci Hosp Vic, Gastroenterol Dept, Vic, Spain

来源：

JOURNAL OF CROHNS & COLITIS | 2024年 / 18卷 / 01期

关键词：

Crohn's disease; ustekinumab; vedolizumab; durability; effectiveness; MAINTENANCE THERAPY; INDUCTION; EFFICACY;

D O I：

10.1093/ecco-jcc/jjad124

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Background Both vedolizumab and ustekinumab are approved for the management of Crohn's disease [CD]. Data on which one would be the most beneficial option when anti-tumour necrosis factor [anti-TNF] agents fail are limited. Aims To compare the durability, effectiveness, and safety of vedolizumab and ustekinumab after anti-TNF failure or intolerance in CD. Methods CD patients from the ENEIDA registry who received vedolizumab or ustekinumab after anti-TNF failure or intolerance were included. Durability and effectiveness were evaluated in both the short and the long term. Effectiveness was defined according to the Harvey-Bradshaw index [HBI]. The safety profile was compared between the two treatments. The propensity score was calculated by the inverse probability weighting method to balance confounder factors. Results A total of 835 patients from 30 centres were included, 207 treated with vedolizumab and 628 with ustekinumab. Dose intensification was performed in 295 patients. Vedolizumab [vs ustekinumab] was associated with a higher risk of treatment discontinuation (hazard ratio [HR] 2.55, 95% confidence interval [CI]: 2.02-3.21), adjusted by corticosteroids at baseline [HR 1.27; 95% CI: 1.00-1.62], moderate-severe activity in HBI [HR 1.79; 95% CI: 1.20-2.48], and high levels of C-reactive protein at baseline [HR 1.06; 95% CI: 1.02-1.10]. The inverse probability weighting method confirmed these results. Clinical response, remission, and corticosteroid-free clinical remission were higher with ustekinumab than with vedolizumab. Both drugs had a low risk of adverse events with no differences between them. Conclusion In CD patients who have failed anti-TNF agents, ustekinumab seems to be superior to vedolizumab in terms of durability and effectiveness in clinical practice. The safety profile is good and similar for both treatments.

引用

页码：65 / 74

页数：10

共 50 条

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