Drug survival of anti-TNF agents compared with vedolizumab as a second-line biological treatment in inflammatory bowel disease : results from nationwide Swedish registers
(2021) In Alimentary Pharmacology and Therapeutics 53(4). p.471-483- Abstract
Background: Comparisons of second-line anti-tumour necrosis factor (TNF) agents and vedolizumab are sparse. Aim: To evaluate the effectiveness of anti-TNF agents compared to vedolizumab as second-line biologics in inflammatory bowel disease (IBD). Methods: A propensity score-matched cohort was created using Swedish nationwide registers. Patients with Crohn's disease or ulcerative colitis, exposed to first-line anti-TNF treatment, who initiated a second anti-TNF agent or vedolizumab in 2014-2016 (N = 1363) were included. The primary outcome was drug survival at 12 months. Secondarily, we assessed survival without IBD-related hospitalisation, IBD-related surgery, antibiotics, or hospitalisation because of infection, and also... (More)
Background: Comparisons of second-line anti-tumour necrosis factor (TNF) agents and vedolizumab are sparse. Aim: To evaluate the effectiveness of anti-TNF agents compared to vedolizumab as second-line biologics in inflammatory bowel disease (IBD). Methods: A propensity score-matched cohort was created using Swedish nationwide registers. Patients with Crohn's disease or ulcerative colitis, exposed to first-line anti-TNF treatment, who initiated a second anti-TNF agent or vedolizumab in 2014-2016 (N = 1363) were included. The primary outcome was drug survival at 12 months. Secondarily, we assessed survival without IBD-related hospitalisation, IBD-related surgery, antibiotics, or hospitalisation because of infection, and also corticosteroid exposure. Results: After 1:1 propensity score matching, 400 patients (Crohn's disease, N = 198; ulcerative colitis, N = 202) remained. For Crohn's disease, drug survival was 73% in the vedolizumab group vs 74% in the anti-TNF group (difference: 1 percentage point; 95% confidence interval [CI]:-11-13; P = 0.87). Survival without IBD-related hospitalisation (82% vs 88%), surgery (82% vs 89%), antibiotics (65% vs 71%), hospitalisation due to infection (95% vs 88%) and corticosteroids (58% vs 48%) were not statistically significantly different between groups. For ulcerative colitis, drug survival was 69% in the vedolizumab group vs 62% in the anti-TNF group (difference: −7 percentage points; 95% CI: −20 to 6; P = 0.30). Vedolizumab-treated patients had lower survival without IBD-related hospitalisation (82% vs 93%, P = 0.02). Survival without colectomy (93% vs 97%), antibiotics (81% vs 70%), hospitalisation due to infection (92% vs 92%) and corticosteroids (58% vs 48%) were not statistically significantly different. Conclusions: Based on Swedish clinical practice, the effectiveness and safety of second-line anti-TNF and vedolizumab at 12 months appeared largely similar.
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- author
- Rundquist, Sara ; Sachs, Michael C. ; Eriksson, Carl ; Olén, Ola ; Montgomery, Scott and Halfvarson, Jonas
- contributor
- Andersson, Marie ; Grip, Olof LU and Strid, Hans
- author collaboration
- publishing date
- 2021-02
- type
- Contribution to journal
- publication status
- published
- in
- Alimentary Pharmacology and Therapeutics
- volume
- 53
- issue
- 4
- pages
- 471 - 483
- publisher
- Wiley-Blackwell
- external identifiers
-
- scopus:85100804411
- pmid:33340426
- ISSN
- 0269-2813
- DOI
- 10.1111/apt.16193
- language
- English
- LU publication?
- no
- additional info
- Funding Information: This study was funded in part by Takeda Pharma AB, grant number IISR‐2017‐101937. The study design, collection, analysis and interpretation of data and drafting of manuscript were solely done by the authors without contribution from any of the funding organisations. Funding Information: : SR has served as a speaker for Takeda and has received research funding from the research committee in Region Örebro County and the Regional Agreement on Medical Training and Clinical Research between Region Örebro County and Örebro University: ALF. CE has served as a speaker, a consultant and an advisory board member for Takeda, Janssen Cilag, Pfizer, Abbvie, and has received research funding from the Regional Agreement on Medical Training and Clinical Research between Region Örebro County and Örebro University: ALF. OO has served as a speaker, a consultant and an advisory board member for Janssen, Ferring, Pfizer and Takeda, and has received research funding from the Swedish Medical Society, The Young Scholar Award from the Strategic Research Area Epidemiology program at Karolinska Institutet and the Regional Agreement on Medical Training and Clinical Research between Stockholm County Council and Karolinska Institutet: ALF. JH has served as a speaker, a consultant and an advisory board member for Abbvie, Celgene, Celltrion, Ferring, Hospira, Janssen, Medivir, MSD, Olink Proteomics, Pfizer, Prometheus Laboratories Inc, RenapharmaVifor, Sandoz, Shire, Takeda, Thermo Fisher and Tillotts Pharma. JH has received research funding from Janssen, MSD and Takeda. MS and SM. Declaration of personal interests Funding Information: This study was funded in part by Takeda Pharma AB, grant number IISR-2017-101937. The study design, collection, analysis and interpretation of data and drafting of manuscript were solely done by the authors without contribution from any of the funding organisations. Declaration of personal interests: SR has served as a speaker for Takeda and has received research funding from the research committee in Region Örebro County and the Regional Agreement on Medical Training and Clinical Research between Region Örebro County and Örebro University: ALF. CE has served as a speaker, a consultant and an advisory board member for Takeda, Janssen Cilag, Pfizer, Abbvie, and has received research funding from the Regional Agreement on Medical Training and Clinical Research between Region Örebro County and Örebro University: ALF. OO has served as a speaker, a consultant and an advisory board member for Janssen, Ferring, Pfizer and Takeda, and has received research funding from the Swedish Medical Society, The Young Scholar Award from the Strategic Research Area Epidemiology program at Karolinska Institutet and the Regional Agreement on Medical Training and Clinical Research between Stockholm County Council and Karolinska Institutet: ALF. JH has served as a speaker, a consultant and an advisory board member for Abbvie, Celgene, Celltrion, Ferring, Hospira, Janssen, Medivir, MSD, Olink Proteomics, Pfizer, Prometheus Laboratories Inc, RenapharmaVifor, Sandoz, Shire, Takeda, Thermo Fisher and Tillotts Pharma. JH has received research funding from Janssen, MSD and Takeda. MS and SM. Publisher Copyright: © 2020 The Authors. Alimentary Pharmacology & Therapeutics published by John Wiley & Sons Ltd
- id
- f2c72089-25a7-4991-b268-959474689fe5
- date added to LUP
- 2022-09-14 14:19:50
- date last changed
- 2024-06-13 19:27:50
@article{f2c72089-25a7-4991-b268-959474689fe5,
abstract = {{<p>Background: Comparisons of second-line anti-tumour necrosis factor (TNF) agents and vedolizumab are sparse. Aim: To evaluate the effectiveness of anti-TNF agents compared to vedolizumab as second-line biologics in inflammatory bowel disease (IBD). Methods: A propensity score-matched cohort was created using Swedish nationwide registers. Patients with Crohn's disease or ulcerative colitis, exposed to first-line anti-TNF treatment, who initiated a second anti-TNF agent or vedolizumab in 2014-2016 (N = 1363) were included. The primary outcome was drug survival at 12 months. Secondarily, we assessed survival without IBD-related hospitalisation, IBD-related surgery, antibiotics, or hospitalisation because of infection, and also corticosteroid exposure. Results: After 1:1 propensity score matching, 400 patients (Crohn's disease, N = 198; ulcerative colitis, N = 202) remained. For Crohn's disease, drug survival was 73% in the vedolizumab group vs 74% in the anti-TNF group (difference: 1 percentage point; 95% confidence interval [CI]:-11-13; P = 0.87). Survival without IBD-related hospitalisation (82% vs 88%), surgery (82% vs 89%), antibiotics (65% vs 71%), hospitalisation due to infection (95% vs 88%) and corticosteroids (58% vs 48%) were not statistically significantly different between groups. For ulcerative colitis, drug survival was 69% in the vedolizumab group vs 62% in the anti-TNF group (difference: −7 percentage points; 95% CI: −20 to 6; P = 0.30). Vedolizumab-treated patients had lower survival without IBD-related hospitalisation (82% vs 93%, P = 0.02). Survival without colectomy (93% vs 97%), antibiotics (81% vs 70%), hospitalisation due to infection (92% vs 92%) and corticosteroids (58% vs 48%) were not statistically significantly different. Conclusions: Based on Swedish clinical practice, the effectiveness and safety of second-line anti-TNF and vedolizumab at 12 months appeared largely similar.</p>}},
author = {{Rundquist, Sara and Sachs, Michael C. and Eriksson, Carl and Olén, Ola and Montgomery, Scott and Halfvarson, Jonas}},
issn = {{0269-2813}},
language = {{eng}},
number = {{4}},
pages = {{471--483}},
publisher = {{Wiley-Blackwell}},
series = {{Alimentary Pharmacology and Therapeutics}},
title = {{Drug survival of anti-TNF agents compared with vedolizumab as a second-line biological treatment in inflammatory bowel disease : results from nationwide Swedish registers}},
url = {{http://dx.doi.org/10.1111/apt.16193}},
doi = {{10.1111/apt.16193}},
volume = {{53}},
year = {{2021}},
}