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Comparison of short‐ and long‐term effectiveness between ustekinumab and vedolizumab in patients with Crohn's disease refractory to anti‐tumour necrosis factor therapy
Summary Background The best option between vedolizumab and ustekinumab after anti‐tumour necrosis factor (TNF) failure remains unclear in Crohn's disease. Aims To compare the short‐ and long‐term effectiveness of vedolizumab and ustekinumab in Crohn's disease patients with prior anti‐TNF e...
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| Published in: | Alimentary Pharmacology & Therapeutics (Suppl) 2021-06, Vol.53 (12), p.1289-1299 |
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| container_end_page | 1299 |
| container_issue | 12 |
| container_start_page | 1289 |
| container_title | Alimentary Pharmacology & Therapeutics (Suppl) |
| container_volume | 53 |
| creator | Manlay, Luc Boschetti, Gilles Pereira, Bruno Flourié, Bernard Dapoigny, Michel Reymond, Maud Sollelis, Elisa Gay, Claire Boube, Mathilde Buisson, Anthony Nancey, Stéphane |
| description | Summary
Background
The best option between vedolizumab and ustekinumab after anti‐tumour necrosis factor (TNF) failure remains unclear in Crohn's disease.
Aims
To compare the short‐ and long‐term effectiveness of vedolizumab and ustekinumab in Crohn's disease patients with prior anti‐TNF exposure.
Methods
All Crohn's disease patients treated with ustekinumab or vedolizumab after exposure to at least one anti‐TNF agent were included from two referral centres. Primary endpoint was corticosteroid‐free clinical remission defined as Crohn's disease activity index |
| doi_str_mv | 10.1111/apt.16377 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_hal_p</sourceid><recordid>TN_cdi_hal_primary_oai_HAL_hal_03299886v1</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2531319761</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3877-7d127b60460fdc53c87769addfdafaf01a17249da5c344a9a7f00927347bb363</originalsourceid><addsrcrecordid>eNp1kU9uEzEUh0cIRNPCggsgSywQi2n9Z2LHyygCihQJFtlbnvEz45KxB9uTKKw4AhfhUpykTlLKCm9sP33vs59-VfWK4GtS1o0e8zXhTIgn1YwwPq8pZvxpNcOUy5ouCLuoLlO6wxhzgenz6oIxiaWkeFb9XoVh1NGl4FGwKPUh5j8_fyHtDdoG_7WcM8QBgbXQZbcDDymhFvIewKMpZfjm_DTo9tSxAxO27sfp7jwadXbgc0J7l3u0iqH3bxMyLoFOgCLYqLsc4gHlUNqzOz42DWGKyEMXQ3IJ2ROBcg9Rj4cX1TOrtwlePuxX1ebD-83qtl5__vhptVzXHVsIUQtDqGg5bji2ppuzrhS51MZYo622mGgiaCONnnesabTUwmIsqWCNaFvG2VX17qzt9VaN0Q06HlTQTt0u1-pYw4xKuVjwHSnsmzM7xvB9gpTVXRnAl98pOmeEESk4-Wc8jpXK5I9agtUxQ1UyVKcMC_v6wTi1A5hH8m9oBbg5A3u3hcP_TWr5ZXNW3gN-LKx6</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2531319761</pqid></control><display><type>article</type><title>Comparison of short‐ and long‐term effectiveness between ustekinumab and vedolizumab in patients with Crohn's disease refractory to anti‐tumour necrosis factor therapy</title><source>Wiley</source><creator>Manlay, Luc ; Boschetti, Gilles ; Pereira, Bruno ; Flourié, Bernard ; Dapoigny, Michel ; Reymond, Maud ; Sollelis, Elisa ; Gay, Claire ; Boube, Mathilde ; Buisson, Anthony ; Nancey, Stéphane</creator><creatorcontrib>Manlay, Luc ; Boschetti, Gilles ; Pereira, Bruno ; Flourié, Bernard ; Dapoigny, Michel ; Reymond, Maud ; Sollelis, Elisa ; Gay, Claire ; Boube, Mathilde ; Buisson, Anthony ; Nancey, Stéphane</creatorcontrib><description>Summary
Background
The best option between vedolizumab and ustekinumab after anti‐tumour necrosis factor (TNF) failure remains unclear in Crohn's disease.
Aims
To compare the short‐ and long‐term effectiveness of vedolizumab and ustekinumab in Crohn's disease patients with prior anti‐TNF exposure.
Methods
All Crohn's disease patients treated with ustekinumab or vedolizumab after exposure to at least one anti‐TNF agent were included from two referral centres. Primary endpoint was corticosteroid‐free clinical remission defined as Crohn's disease activity index <150 at week 54. Deep remission (corticosteroid‐free clinical remission and faecal calprotectin <100 µg/g) was assessed at week 14. Propensity‐matched analyses were applied to make the two groups comparable.
Results
Overall, 312 patients (ustekinumab = 224 and vedolizumab = 88) were included. After propensity score analysis, ustekinumab was more effective to achieve corticosteroid‐free clinical remission at week 54 (49.3% vs 41.2%, P = 0.04) and deep remission at Week 14 (25.9% vs 3.8%, P = 0.02) than vedolizumab. The rate of primary nonresponders (6.7% vs 14.8%, P = 0.034) and the long‐term risk of drug discontinuation due to therapeutic failure (HR = 1.53 [1.04‐2.07], P = 0.029) were lower in patients treated with ustekinumab compared with vedolizumab. Predictors of ustekinumab failure were complicated phenotype (odds ratio [OR] = 2.35 [1.31‐4.22]; P = 0.004) and anti‐TNF primary non‐response (OR = 2.55 [1.27‐5.12]; P = 0.008). We did not find any predictor of corticosteroid‐free clinical remission in patients treated with vedolizumab. Vedolizumab was less effective than ustekinumab in patients >35 years old (OR = 0.41 [0.19‐0.87]), with noncomplicated phenotype (OR=0.42 [0.18‐0.96]), no prior bowel resection (OR = 0.49 [0.24‐0.96]), and no steroids at baseline (OR=0.47 [0.23‐0.97]).
Conclusion
Ustekinumab was more effective to achieve early and long‐term effectiveness than vedolizumab in Crohn's disease patients who previously failed response to anti‐TNF agents.</description><identifier>ISSN: 0269-2813</identifier><identifier>ISSN: 0953-0673</identifier><identifier>EISSN: 1365-2036</identifier><identifier>DOI: 10.1111/apt.16377</identifier><identifier>PMID: 33909920</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Antibodies, Monoclonal, Humanized / therapeutic use ; Corticosteroids ; Crohn Disease / drug therapy ; Crohn's disease ; Human health and pathology ; Hépatology and Gastroenterology ; Life Sciences ; Pharmaceutical sciences ; Phenotypes ; Remission ; Steroid hormones ; Treatment Outcome ; Tumor necrosis factor ; Tumor Necrosis Factor Inhibitors ; Tumor necrosis factor-TNF ; Tumors ; Ustekinumab / therapeutic use</subject><ispartof>Alimentary Pharmacology & Therapeutics (Suppl), 2021-06, Vol.53 (12), p.1289-1299</ispartof><rights>2021 John Wiley & Sons Ltd</rights><rights>2021 John Wiley & Sons Ltd.</rights><rights>Copyright © 2021 John Wiley & Sons Ltd</rights><rights>Attribution</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3877-7d127b60460fdc53c87769addfdafaf01a17249da5c344a9a7f00927347bb363</citedby><cites>FETCH-LOGICAL-c3877-7d127b60460fdc53c87769addfdafaf01a17249da5c344a9a7f00927347bb363</cites><orcidid>0000-0002-6347-409X ; 0000-0003-2088-1442</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,777,781,882,27905,27906</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33909920$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://hal.inrae.fr/hal-03299886$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Manlay, Luc</creatorcontrib><creatorcontrib>Boschetti, Gilles</creatorcontrib><creatorcontrib>Pereira, Bruno</creatorcontrib><creatorcontrib>Flourié, Bernard</creatorcontrib><creatorcontrib>Dapoigny, Michel</creatorcontrib><creatorcontrib>Reymond, Maud</creatorcontrib><creatorcontrib>Sollelis, Elisa</creatorcontrib><creatorcontrib>Gay, Claire</creatorcontrib><creatorcontrib>Boube, Mathilde</creatorcontrib><creatorcontrib>Buisson, Anthony</creatorcontrib><creatorcontrib>Nancey, Stéphane</creatorcontrib><title>Comparison of short‐ and long‐term effectiveness between ustekinumab and vedolizumab in patients with Crohn's disease refractory to anti‐tumour necrosis factor therapy</title><title>Alimentary Pharmacology & Therapeutics (Suppl)</title><addtitle>Aliment Pharmacol Ther</addtitle><description>Summary
Background
The best option between vedolizumab and ustekinumab after anti‐tumour necrosis factor (TNF) failure remains unclear in Crohn's disease.
Aims
To compare the short‐ and long‐term effectiveness of vedolizumab and ustekinumab in Crohn's disease patients with prior anti‐TNF exposure.
Methods
All Crohn's disease patients treated with ustekinumab or vedolizumab after exposure to at least one anti‐TNF agent were included from two referral centres. Primary endpoint was corticosteroid‐free clinical remission defined as Crohn's disease activity index <150 at week 54. Deep remission (corticosteroid‐free clinical remission and faecal calprotectin <100 µg/g) was assessed at week 14. Propensity‐matched analyses were applied to make the two groups comparable.
Results
Overall, 312 patients (ustekinumab = 224 and vedolizumab = 88) were included. After propensity score analysis, ustekinumab was more effective to achieve corticosteroid‐free clinical remission at week 54 (49.3% vs 41.2%, P = 0.04) and deep remission at Week 14 (25.9% vs 3.8%, P = 0.02) than vedolizumab. The rate of primary nonresponders (6.7% vs 14.8%, P = 0.034) and the long‐term risk of drug discontinuation due to therapeutic failure (HR = 1.53 [1.04‐2.07], P = 0.029) were lower in patients treated with ustekinumab compared with vedolizumab. Predictors of ustekinumab failure were complicated phenotype (odds ratio [OR] = 2.35 [1.31‐4.22]; P = 0.004) and anti‐TNF primary non‐response (OR = 2.55 [1.27‐5.12]; P = 0.008). We did not find any predictor of corticosteroid‐free clinical remission in patients treated with vedolizumab. Vedolizumab was less effective than ustekinumab in patients >35 years old (OR = 0.41 [0.19‐0.87]), with noncomplicated phenotype (OR=0.42 [0.18‐0.96]), no prior bowel resection (OR = 0.49 [0.24‐0.96]), and no steroids at baseline (OR=0.47 [0.23‐0.97]).
Conclusion
Ustekinumab was more effective to achieve early and long‐term effectiveness than vedolizumab in Crohn's disease patients who previously failed response to anti‐TNF agents.</description><subject>Antibodies, Monoclonal, Humanized / therapeutic use</subject><subject>Corticosteroids</subject><subject>Crohn Disease / drug therapy</subject><subject>Crohn's disease</subject><subject>Human health and pathology</subject><subject>Hépatology and Gastroenterology</subject><subject>Life Sciences</subject><subject>Pharmaceutical sciences</subject><subject>Phenotypes</subject><subject>Remission</subject><subject>Steroid hormones</subject><subject>Treatment Outcome</subject><subject>Tumor necrosis factor</subject><subject>Tumor Necrosis Factor Inhibitors</subject><subject>Tumor necrosis factor-TNF</subject><subject>Tumors</subject><subject>Ustekinumab / therapeutic use</subject><issn>0269-2813</issn><issn>0953-0673</issn><issn>1365-2036</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp1kU9uEzEUh0cIRNPCggsgSywQi2n9Z2LHyygCihQJFtlbnvEz45KxB9uTKKw4AhfhUpykTlLKCm9sP33vs59-VfWK4GtS1o0e8zXhTIgn1YwwPq8pZvxpNcOUy5ouCLuoLlO6wxhzgenz6oIxiaWkeFb9XoVh1NGl4FGwKPUh5j8_fyHtDdoG_7WcM8QBgbXQZbcDDymhFvIewKMpZfjm_DTo9tSxAxO27sfp7jwadXbgc0J7l3u0iqH3bxMyLoFOgCLYqLsc4gHlUNqzOz42DWGKyEMXQ3IJ2ROBcg9Rj4cX1TOrtwlePuxX1ebD-83qtl5__vhptVzXHVsIUQtDqGg5bji2ppuzrhS51MZYo622mGgiaCONnnesabTUwmIsqWCNaFvG2VX17qzt9VaN0Q06HlTQTt0u1-pYw4xKuVjwHSnsmzM7xvB9gpTVXRnAl98pOmeEESk4-Wc8jpXK5I9agtUxQ1UyVKcMC_v6wTi1A5hH8m9oBbg5A3u3hcP_TWr5ZXNW3gN-LKx6</recordid><startdate>202106</startdate><enddate>202106</enddate><creator>Manlay, Luc</creator><creator>Boschetti, Gilles</creator><creator>Pereira, Bruno</creator><creator>Flourié, Bernard</creator><creator>Dapoigny, Michel</creator><creator>Reymond, Maud</creator><creator>Sollelis, Elisa</creator><creator>Gay, Claire</creator><creator>Boube, Mathilde</creator><creator>Buisson, Anthony</creator><creator>Nancey, Stéphane</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>7U9</scope><scope>H94</scope><scope>M7N</scope><scope>1XC</scope><orcidid>https://orcid.org/0000-0002-6347-409X</orcidid><orcidid>https://orcid.org/0000-0003-2088-1442</orcidid></search><sort><creationdate>202106</creationdate><title>Comparison of short‐ and long‐term effectiveness between ustekinumab and vedolizumab in patients with Crohn's disease refractory to anti‐tumour necrosis factor therapy</title><author>Manlay, Luc ; Boschetti, Gilles ; Pereira, Bruno ; Flourié, Bernard ; Dapoigny, Michel ; Reymond, Maud ; Sollelis, Elisa ; Gay, Claire ; Boube, Mathilde ; Buisson, Anthony ; Nancey, Stéphane</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3877-7d127b60460fdc53c87769addfdafaf01a17249da5c344a9a7f00927347bb363</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Antibodies, Monoclonal, Humanized / therapeutic use</topic><topic>Corticosteroids</topic><topic>Crohn Disease / drug therapy</topic><topic>Crohn's disease</topic><topic>Human health and pathology</topic><topic>Hépatology and Gastroenterology</topic><topic>Life Sciences</topic><topic>Pharmaceutical sciences</topic><topic>Phenotypes</topic><topic>Remission</topic><topic>Steroid hormones</topic><topic>Treatment Outcome</topic><topic>Tumor necrosis factor</topic><topic>Tumor Necrosis Factor Inhibitors</topic><topic>Tumor necrosis factor-TNF</topic><topic>Tumors</topic><topic>Ustekinumab / therapeutic use</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Manlay, Luc</creatorcontrib><creatorcontrib>Boschetti, Gilles</creatorcontrib><creatorcontrib>Pereira, Bruno</creatorcontrib><creatorcontrib>Flourié, Bernard</creatorcontrib><creatorcontrib>Dapoigny, Michel</creatorcontrib><creatorcontrib>Reymond, Maud</creatorcontrib><creatorcontrib>Sollelis, Elisa</creatorcontrib><creatorcontrib>Gay, Claire</creatorcontrib><creatorcontrib>Boube, Mathilde</creatorcontrib><creatorcontrib>Buisson, Anthony</creatorcontrib><creatorcontrib>Nancey, Stéphane</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Hyper Article en Ligne (HAL)</collection><jtitle>Alimentary Pharmacology & Therapeutics (Suppl)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Manlay, Luc</au><au>Boschetti, Gilles</au><au>Pereira, Bruno</au><au>Flourié, Bernard</au><au>Dapoigny, Michel</au><au>Reymond, Maud</au><au>Sollelis, Elisa</au><au>Gay, Claire</au><au>Boube, Mathilde</au><au>Buisson, Anthony</au><au>Nancey, Stéphane</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparison of short‐ and long‐term effectiveness between ustekinumab and vedolizumab in patients with Crohn's disease refractory to anti‐tumour necrosis factor therapy</atitle><jtitle>Alimentary Pharmacology & Therapeutics (Suppl)</jtitle><addtitle>Aliment Pharmacol Ther</addtitle><date>2021-06</date><risdate>2021</risdate><volume>53</volume><issue>12</issue><spage>1289</spage><epage>1299</epage><pages>1289-1299</pages><issn>0269-2813</issn><issn>0953-0673</issn><eissn>1365-2036</eissn><abstract>Summary
Background
The best option between vedolizumab and ustekinumab after anti‐tumour necrosis factor (TNF) failure remains unclear in Crohn's disease.
Aims
To compare the short‐ and long‐term effectiveness of vedolizumab and ustekinumab in Crohn's disease patients with prior anti‐TNF exposure.
Methods
All Crohn's disease patients treated with ustekinumab or vedolizumab after exposure to at least one anti‐TNF agent were included from two referral centres. Primary endpoint was corticosteroid‐free clinical remission defined as Crohn's disease activity index <150 at week 54. Deep remission (corticosteroid‐free clinical remission and faecal calprotectin <100 µg/g) was assessed at week 14. Propensity‐matched analyses were applied to make the two groups comparable.
Results
Overall, 312 patients (ustekinumab = 224 and vedolizumab = 88) were included. After propensity score analysis, ustekinumab was more effective to achieve corticosteroid‐free clinical remission at week 54 (49.3% vs 41.2%, P = 0.04) and deep remission at Week 14 (25.9% vs 3.8%, P = 0.02) than vedolizumab. The rate of primary nonresponders (6.7% vs 14.8%, P = 0.034) and the long‐term risk of drug discontinuation due to therapeutic failure (HR = 1.53 [1.04‐2.07], P = 0.029) were lower in patients treated with ustekinumab compared with vedolizumab. Predictors of ustekinumab failure were complicated phenotype (odds ratio [OR] = 2.35 [1.31‐4.22]; P = 0.004) and anti‐TNF primary non‐response (OR = 2.55 [1.27‐5.12]; P = 0.008). We did not find any predictor of corticosteroid‐free clinical remission in patients treated with vedolizumab. Vedolizumab was less effective than ustekinumab in patients >35 years old (OR = 0.41 [0.19‐0.87]), with noncomplicated phenotype (OR=0.42 [0.18‐0.96]), no prior bowel resection (OR = 0.49 [0.24‐0.96]), and no steroids at baseline (OR=0.47 [0.23‐0.97]).
Conclusion
Ustekinumab was more effective to achieve early and long‐term effectiveness than vedolizumab in Crohn's disease patients who previously failed response to anti‐TNF agents.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>33909920</pmid><doi>10.1111/apt.16377</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0002-6347-409X</orcidid><orcidid>https://orcid.org/0000-0003-2088-1442</orcidid></addata></record> |
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| subjects | Antibodies, Monoclonal, Humanized / therapeutic use Corticosteroids Crohn Disease / drug therapy Crohn's disease Human health and pathology Hépatology and Gastroenterology Life Sciences Pharmaceutical sciences Phenotypes Remission Steroid hormones Treatment Outcome Tumor necrosis factor Tumor Necrosis Factor Inhibitors Tumor necrosis factor-TNF Tumors Ustekinumab / therapeutic use |
| title | Comparison of short‐ and long‐term effectiveness between ustekinumab and vedolizumab in patients with Crohn's disease refractory to anti‐tumour necrosis factor therapy |
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