Anti-TNF therapy for ulcerative colitis in Brazil: a comparative real-world national retrospective multicentric study from the Brazilian study group of IBD (GEDIIB)

Author:

Sassaki Ligia YukieORCID,Magro Daniela OliveiraORCID,Saad-Hossne RogerioORCID,Baima Julio PinheiroORCID,Flores CristinaORCID,Correia Lucianna Motta,Celani Lívia Medeiros SoaresORCID,De Abreu Ferrari Maria De LourdesORCID,Zacharias PatriciaORCID,Feitosa Marley RibeiroORCID,Dos Santos Carlos Henrique MarquesORCID,De Freitas Lins Neto Manoel AlvaroORCID,Quaresma Abel BotelhoORCID,De Lima Junior Sergio FigueiredoORCID,De Vasconcelos Graciana Bandeira SalgadoORCID,Cassol Ornella SariORCID,Dos Santos Pinto ArleneORCID,Kurachi GustavoORCID,Goncalves Filho Francisco de AssisORCID,Gasparini Rodrigo GalhardiORCID,Furlan Thaísa KowalskiORCID,Catapani Wilson RobertoORCID,Coy Cláudio Saddy RodriguesORCID,De Souza Menegassi VivianORCID,Colombo Marilia MajeskiORCID,Fróes Renata de Sá BritoORCID,Teixeira Fabio VieiraORCID,Moraes Antonio CarlosORCID,Santana Genoile OliveiraORCID,Parente José Miguel LuzORCID,Vilela Eduardo GarciaORCID,Queiroz Natália Sousa FreitasORCID,Kotze Paulo GustavoORCID,

Abstract

Abstract Background Anti-TNF therapy represented a landmark in medical treatment of ulcerative colitis (UC). There is lack of data on the efficacy and safety of these agents in Brazilian patients. The present study aimed to analyze rates of clinical and endoscopic remission comparatively, between adalimumab (ADA) and infliximab (IFX), in Brazilian patients with UC, and evaluate factors associated with clinical and endoscopic remission after 1 year of treatment. Methods A national retrospective multicenter study (24 centers) was performed including patients with UC treated with anti-TNF therapy. Outcomes as clinical response and remission, endoscopic remission and secondary loss of response were measured in different time points of the follow-up. Baseline predictive factors of clinical and endoscopic remission at week 52 were evaluated using logistic regression model. Indirect comparisons among groups (ADA and IFX) were performed using Student's t, Pearson χ2 or Fisher's exact test when appropriated, and Kaplan Meier analysis. Results Overall, 393 patients were included (ADA, n = 111; IFX, n = 282). The mean age was 41.86 ± 13.60 years, 61.58% were female, most patients had extensive colitis (62.40%) and 19.39% had previous exposure to a biological agent. Overall, clinical remission rate was 66.78%, 71.62% and 82.82% at weeks 8, 26 and 52, respectively. Remission rates were higher in the IFX group at weeks 26 (75.12% vs. 62.65%, p < 0.0001) and 52 (65.24% vs. 51.35%, p < 0.0001) when compared to ADA. According to Kaplan–Meier survival curve loss of response was less frequent in the Infliximab compared to Adalimumab group (p = 0.001). Overall, endoscopic remission was observed in 50% of patients at week 26 and in 65.98% at week 52, with no difference between the groups (p = 0.114). Colectomy was performed in 23 patients (5.99%). Age, non-prior exposure to biological therapy, use of IFX and endoscopic remission at week 26 were associated with clinical remission after 52 weeks. Variables associated with endoscopic remission were non-prior exposure to biological therapy, and clinical and endoscopic remission at week 26. Conclusions IFX was associated with higher rates of clinical remission after 1 year in comparison to ADA. Non-prior exposure to biological therapy and early response to anti-TNF treatment were associated with higher rates of clinical and endoscopic remission.

Publisher

Springer Science and Business Media LLC

Subject

Gastroenterology,General Medicine

Cited by 1 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3