TY - JOUR
T1 - Clinical Outcomes After First-Line Anti- Tumor-Necrosis-Factor Treatment of Patients With Inflammatory Bowel Disease — A Prospective Multicenter Cohort Study
AU - Zhao, Mirabella
AU - Larsen, Lone
AU - Dige, Anders
AU - Poulsen, Anja
AU - Lo, Bobby
AU - Attauabi, Mohamed
AU - Ovesen, Pernille Dige
AU - Wewer, Mads Damsgaard
AU - Christiansen, Dagmar
AU - Hvas, Christian Lodberg
AU - Petersen, Andreas Munk
AU - Bendtsen, Flemming
AU - Seidelin, Jakob
AU - Burisch, Johan
N1 - © The Author(s) 2024. Published by Oxford University Press on behalf of European Crohn’s and Colitis Organisation. All rights reserved. For commercial re-use, please contact [email protected] for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact [email protected].
PY - 2024/12/19
Y1 - 2024/12/19
N2 - BACKGROUND AND AIMS: Existing findings on outcomes of anti-tumor-necrosis-factor (TNF) therapy in patients with inflammatory bowel diseases (IBD) are largely based on retrospective studies. We aimed to investigate real-world outcomes of anti-TNF therapy and predictors thereof in a prospective IBD cohort.METHODS: In a Danish multicenter cohort of adult bio-naïve patients with IBD treated with anti-TNF, we assessed clinical response and remission to induction therapy using clinical disease activity scoring indices at week 14. In patients who continued treatment beyond the induction period, we also assessed loss of response (LOR), drug withdrawal, and major IBD surgery during maintenance therapy.RESULTS: This study included 774 patients (706 infliximab, 68 adalimumab) followed for a median duration of 125 weeks Clinical response was achieved in 209/331 (67.4%) of ulcerative colitis (UC) and 125/197 (74.0%) of Crohn's disease (CD) patients, while 143/331 (46.1%) UC and 81/197 (47.9%) CD patients achieved clinical remission. In 294 UC and 309 CD patients who received maintenance therapy, 86/294 (29.3%) UC and 78/309 (25.2%) CD patients experienced LOR. Active smoking and less severe disease activity predicted favorable outcomes in UC, while short disease duration, colonic disease, non-stricturing behavior, and concomitant immunomodulator therapy predicted favorable outcomes in CD.CONCLUSIONS: Clinical response was achieved in two in three UC and three in four CD patients, meanwhile, one-third of UC and one-fourth of CD patients experienced LOR despite the short disease duration in this study. Several clinical features were associated with outcomes and may be useful predictors of anti-TNF treatment response.
AB - BACKGROUND AND AIMS: Existing findings on outcomes of anti-tumor-necrosis-factor (TNF) therapy in patients with inflammatory bowel diseases (IBD) are largely based on retrospective studies. We aimed to investigate real-world outcomes of anti-TNF therapy and predictors thereof in a prospective IBD cohort.METHODS: In a Danish multicenter cohort of adult bio-naïve patients with IBD treated with anti-TNF, we assessed clinical response and remission to induction therapy using clinical disease activity scoring indices at week 14. In patients who continued treatment beyond the induction period, we also assessed loss of response (LOR), drug withdrawal, and major IBD surgery during maintenance therapy.RESULTS: This study included 774 patients (706 infliximab, 68 adalimumab) followed for a median duration of 125 weeks Clinical response was achieved in 209/331 (67.4%) of ulcerative colitis (UC) and 125/197 (74.0%) of Crohn's disease (CD) patients, while 143/331 (46.1%) UC and 81/197 (47.9%) CD patients achieved clinical remission. In 294 UC and 309 CD patients who received maintenance therapy, 86/294 (29.3%) UC and 78/309 (25.2%) CD patients experienced LOR. Active smoking and less severe disease activity predicted favorable outcomes in UC, while short disease duration, colonic disease, non-stricturing behavior, and concomitant immunomodulator therapy predicted favorable outcomes in CD.CONCLUSIONS: Clinical response was achieved in two in three UC and three in four CD patients, meanwhile, one-third of UC and one-fourth of CD patients experienced LOR despite the short disease duration in this study. Several clinical features were associated with outcomes and may be useful predictors of anti-TNF treatment response.
U2 - 10.1093/ecco-jcc/jjae192
DO - 10.1093/ecco-jcc/jjae192
M3 - Journal article
C2 - 39700468
JO - Journal of Crohn's & colitis
JF - Journal of Crohn's & colitis
SN - 1873-9946
ER -