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Ustekinumab Versus ...
Ustekinumab Versus Anti-tumour Necrosis Factor Alpha Agents as Second-Line Biologics in Crohn's Disease
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- Eriksson, Carl, 1981- (author)
- 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
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- Söderling, Jonas (author)
- Karolinska Institutet
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- Karlqvist, Sara, 1992- (author)
- Örebro universitet,Institutionen för medicinska vetenskaper,Department of Gastroenterology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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- Bröms, Gabriella (author)
- Karolinska Institutet
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- Everhov, Åsa H. (author)
- Karolinska Institutet
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- Bergemalm, Daniel, 1977- (author)
- Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Department of Gastroenterology
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- Ludvigsson, Jonas F., 1969- (author)
- Karolinska Institutet
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- Olén, Ola (author)
- Karolinska Institutet
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- Halfvarson, Jonas, 1970- (author)
- Örebro universitet,Institutionen för medicinska vetenskaper,Department of Gastroenterology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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SWIBREG study group, - (contributor)
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(creator_code:org_t)
- 2023-03-17
- 2023
- English.
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In: Digestive Diseases and Sciences. - : Springer-Verlag New York. - 0163-2116 .- 1573-2568. ; 68:7, s. 3119-3128
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Abstract
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- 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.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Gastroenterologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Gastroenterology and Hepatology (hsv//eng)
Keyword
- Anti-TNF
- Comparative effectiveness
- Comparative safety
- Crohn’s disease
- Population-based study
- Ustekinumab
Publication and Content Type
- ref (subject category)
- art (subject category)
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Eriksson, Carl, ...
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Söderling, Jonas
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Karlqvist, Sara, ...
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Bröms, Gabriella
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Everhov, Åsa H.
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Bergemalm, Danie ...
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Ludvigsson, Jona ...
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Olén, Ola
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Halfvarson, Jona ...
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SWIBREG study gr ...
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Gastroenterology ...
- Articles in the publication
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Digestive Diseas ...
- By the university
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Örebro University
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Karolinska Institutet