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  • Eriksson, Carl,1981-Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Department of Gastroenterology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden; Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden (author)

Ustekinumab Versus Anti-tumour Necrosis Factor Alpha Agents as Second-Line Biologics in Crohn's Disease

  • Article/chapterEnglish2023

Publisher, publication year, extent ...

  • 2023-03-17
  • Springer-Verlag New York,2023
  • printrdacarrier

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  • LIBRIS-ID:oai:DiVA.org:oru-105110
  • https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-105110URI
  • https://doi.org/10.1007/s10620-023-07897-2DOI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:152296734URI

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  • Language:English
  • Summary in:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • Funding agencies:Johnson & Johnson USA Janssen Biotech Inc CNTO1275CRD0005Stockholm Region Clinical Postdoctoral Researcher GrantStrategic Research Area Epidemiology program at Karolinska Institutet 
  • BACKGROUND: There are little data on positioning biologics in Crohn's disease (CD). AIMS: We aimed to assess the comparative effectiveness and safety of ustekinumab vs tumour necrosis factor-alpha (anti-TNF) agents after first-line treatment with anti-TNF in CD.METHODS: We used Swedish nationwide registers to identify patients with CD, exposed to anti-TNF who initiated second-line biologic treatment with ustekinumab or second-line anti-TNF therapy. Nearest neighbour 1:1 propensity score matching (PSM) was used to balance the groups. The primary outcome was 3-year drug survival used as a proxy for effectiveness. Secondary outcomes included drug survival without hospital admission, CD-related surgery, antibiotics, hospitalization due to infection and exposure to corticosteroids.RESULTS: Some 312 patients remained after PSM. Drug survival at 3 years was 35% (95% CI 26-44%) in ustekinumab compared to 36% (95% CI 28-44%) in anti-TNF-treated patients (p = 0.72). No statistically significant differences were observed between the groups in 3-year survival without hospital admission (72% vs 70%, p = 0.99), surgery (87% vs 92%, p = 0.17), hospital admission due to infection (92% vs 92%, p = 0.31) or prescription of antibiotics (49% vs 50%, p = 0.56). The proportion of patients continuing second-line biologic therapy did not differ by reason for ending first-line anti-TNF (lack of response vs intolerance) or by type of first-line anti-TNF (adalimumab vs infliximab).CONCLUSION: Based on data from Swedish routine care, no clinically relevant differences in effectiveness or safety of second-line ustekinumab vs anti-TNF treatment were observed in patients with CD with prior exposure to anti-TNF.

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  • Söderling, JonasKarolinska Institutet (author)
  • Karlqvist, Sara,1992-Örebro universitet,Institutionen för medicinska vetenskaper,Department of Gastroenterology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden(Swepub:oru)srt (author)
  • Bröms, GabriellaKarolinska Institutet (author)
  • Everhov, Åsa H.Karolinska Institutet (author)
  • Bergemalm, Daniel,1977-Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Department of Gastroenterology(Swepub:oru)dbm (author)
  • Ludvigsson, Jonas F.,1969-Karolinska Institutet(Swepub:oru)jsln (author)
  • Olén, OlaKarolinska Institutet (author)
  • Halfvarson, Jonas,1970-Örebro universitet,Institutionen för medicinska vetenskaper,Department of Gastroenterology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden(Swepub:oru)jshn (author)
  • SWIBREG study group, - (contributor)
  • Örebro universitetInstitutionen för medicinska vetenskaper (creator_code:org_t)

Related titles

  • In:Digestive Diseases and Sciences: Springer-Verlag New York68:7, s. 3119-31280163-21161573-2568

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