1. Comparison of short- and long-term effectiveness between ustekinumab and vedolizumab in patients with Crohn's disease refractory to anti-tumour necrosis factor therapy
- Author
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Luc Manlay, Gilles Boschetti, Bruno Pereira, Bernard Flourié, Michel Dapoigny, Maud Reymond, Elisa Sollelis, Claire Gay, Mathilde Boube, Anthony Buisson, Stéphane Nancey, Service d'Hépatologie Gastro-entérologie [CHU Clermont-Ferrand], CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, Service d'Hépatogastroentérologie [CHU Lyon-Sud], Hospices Civils de Lyon (HCL), Centre International de Recherche en Infectiologie - UMR (CIRI), Institut National de la Santé et de la Recherche Médicale (INSERM)-École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS), Unité de Biostatistiques [CHU Clermont-Ferrand], Direction de la recherche clinique et de l’innovation [CHU Clermont-Ferrand] (DRCI), Microbes, Intestin, Inflammation et Susceptibilité de l'Hôte (M2iSH), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre de Recherche en Nutrition Humaine d'Auvergne (CRNH d'Auvergne)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Université Clermont Auvergne (UCA), École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Molé, Christine, Centre International de Recherche en Infectiologie (CIRI), École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL), and Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)
- Subjects
Adult ,medicine.medical_specialty ,medicine.medical_treatment ,Antibodies, Monoclonal, Humanized ,Gastroenterology ,Vedolizumab ,MESH: Ustekinumab* / therapeutic use ,03 medical and health sciences ,0302 clinical medicine ,Refractory ,Crohn Disease ,Internal medicine ,Ustekinumab ,medicine ,Clinical endpoint ,Humans ,Pharmacology (medical) ,030212 general & internal medicine ,MESH: Treatment Outcome ,Crohn's disease ,Hepatology ,business.industry ,MESH: Antibodies, Monoclonal, Humanized / therapeutic use ,[SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology ,Bowel resection ,Odds ratio ,[SDV.SP]Life Sciences [q-bio]/Pharmaceutical sciences ,medicine.disease ,[SDV.MHEP.HEG] Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology ,3. Good health ,[SDV.SP] Life Sciences [q-bio]/Pharmaceutical sciences ,Treatment Outcome ,MESH: Crohn Disease* / drug therapy ,Monoclonal ,030211 gastroenterology & hepatology ,MESH: Tumor Necrosis Factor Inhibitors ,Tumor Necrosis Factor Inhibitors ,business ,medicine.drug - Abstract
International audience; 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 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.
- Published
- 2021
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