The effectiveness of second- and-third-line biologics in perianal Crohn’s disease—a multicenter propensity score-matched study

BACKGROUND & AIMS: Anti-tumor necrosis factor-alpha inhibitors (anti-TNFs) are the established treatment for perianal Crohn's disease (pCD), but relapse and non-response are common. Data on 2nd- and 3rd-line biologics are limited. We present the first direct comparison of 2nd - and 3rd -lin...

Teljes leírás

Elmentve itt :
Bibliográfiai részletek
Szerzők: Shani Uria
State Monica
Mateescu Radu Bogdan
Davidoiu Ana-Maria
Negreanu Lucian
Silva Isabel
Magro Fernando
Lees Charlie W
Plevris Nikolas
Roblin Xavier
Castellet-Farrus Silvia
Gonzalez Lama Yago
Wang Shanshan
Farkas Bernadett
Farkas Klaudia
et al
Dokumentumtípus: Cikk
Megjelent: 2025
Sorozat:JOURNAL OF CROHNS & COLITIS 19 No. 6
Tárgyszavak:
doi:10.1093/ecco-jcc/jjaf099

mtmt:36192916
Online Access:http://publicatio.bibl.u-szeged.hu/37233
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245 1 4 |a The effectiveness of second- and-third-line biologics in perianal Crohn’s disease—a multicenter propensity score-matched study  |h [elektronikus dokumentum] /  |c  Shani Uria 
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490 0 |a JOURNAL OF CROHNS & COLITIS  |v 19 No. 6 
520 3 |a BACKGROUND & AIMS: Anti-tumor necrosis factor-alpha inhibitors (anti-TNFs) are the established treatment for perianal Crohn's disease (pCD), but relapse and non-response are common. Data on 2nd- and 3rd-line biologics are limited. We present the first direct comparison of 2nd - and 3rd -line biologics in pCD patients with active perianal disease previously treated with 1st-line anti-TNFs.; METHODS: A multicenter retrospective cohort study included adult patients with pCD who failed 1st-line anti-TNF. The primary outcome was clinical perianal response, with secondary outcomes of radiological response (magnetic resonance imaging [MRI] or transrectal ultrasound [TRUS]) and healing, and clinical remission. Propensity-score matching (PSM) was used to adjust for baseline differences.; RESULTS: A total of 486 pCD patients from 23 IBD centers were included, with 333/486 (68.5%) and 216/263 (82.1%) matched by PSM in the 2nd and 3rd -line treatment groups, respectively. In the 2nd -line group, 62/78 (79.5%) of ustekinumab (UST)-treated patients achieved clinical perianal response, compared to 46/78 (58.9%) with vedolizumab (VDZ) (OR 4.47, 95% CI 1.94-10.28, p<0.001) and 38/78 (48.7%) with anti-TNFs (OR 5.29, 95% CI 2.39-11.71, p<0.001). In the 3rd-line group, 38/49 (77.6%) of UST-treated patients achieved clinical perianal response, compared to 29/49 (59.2%) with VDZ (OR 9.96, 95% CI 2.6-38.4, p<0.001) and 27/49 (55.1%) with anti-TNFs (OR 12.03, 95% CI 2.99-48.47, p<0.001). UST-treated patients also had higher radiological response rates than VDZ (OR 3.28, 95% CI 1.07-10.07, p=0.038).; CONCLUSION: In pCD patients failing anti-TNFs as 1st-line treatment, ustekinumab may be more effective than vedolizumab or another anti-TNFs as 2nd or 3rd-line therapy. © The Author(s) 2025. Published by Oxford University Press on behalf of European Crohns and Colitis Organisation. All rights reserved. For commercial re-use, please contact reprints@oup.com 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 sitefor further information please contact journals.permissions@oup.com. 
650 4 |a Klinikai orvostan 
700 0 1 |a State Monica  |e aut 
700 0 1 |a Mateescu Radu Bogdan  |e aut 
700 0 1 |a Davidoiu Ana-Maria  |e aut 
700 0 1 |a Negreanu Lucian  |e aut 
700 0 1 |a Silva Isabel  |e aut 
700 0 1 |a Magro Fernando  |e aut 
700 0 1 |a Lees Charlie W  |e aut 
700 0 1 |a Plevris Nikolas  |e aut 
700 0 1 |a Roblin Xavier  |e aut 
700 0 2 |a Castellet-Farrus Silvia  |e aut 
700 0 2 |a Gonzalez Lama Yago  |e aut 
700 0 2 |a Wang Shanshan  |e aut 
700 0 2 |a Farkas Bernadett  |e aut 
700 0 2 |a Farkas Klaudia  |e aut 
700 0 2 |a et al.  |e aut 
856 4 0 |u http://publicatio.bibl.u-szeged.hu/37233/1/jjaf099.pdf  |z Dokumentum-elérés