Analysis of TNF-antagonist switch over time and associated risk factors in the Swiss Inflammatory Bowel Disease Cohort

Hiroz, Philippe; Vavricka, Stephan; Fournier, Nicolas; Safroneeva, Ekaterina; Pittet, Valérie; Rogler, Gerhard; Schöpfer, Alain; Juillerat, Pascal; Swiss Inflammatory Bowel Diseases Cohort Study Group, The (2014). Analysis of TNF-antagonist switch over time and associated risk factors in the Swiss Inflammatory Bowel Disease Cohort. Scandinavian journal of gastroenterology, 49(10), pp. 1207-1218. Informa Healthcare 10.3109/00365521.2014.946082

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BACKGROUND AND AIMS

Limited data from large cohorts are available on tumor necrosis factor (TNF) antagonists (infliximab, adalimumab, certolizumab pegol) switch over time. We aimed to evaluate the prevalence of switching from one TNF antagonist to another and to identify associated risk factors.

METHODS

Data from the Swiss Inflammatory Bowel Diseases Cohort Study (SIBDCS) were analyzed.

RESULTS

Of 1731 patients included into the SIBDCS (956 with Crohn's disease [CD] and 775 with ulcerative colitis [UC]), 347 CD patients (36.3%) and 129 UC patients (16.6%) were treated with at least one TNF antagonist. A total of 53/347 (15.3%) CD patients (median disease duration 9 years) and 20/129 (15.5%) of UC patients (median disease duration 7 years) needed to switch to a second and/or a third TNF antagonist, respectively. Median treatment duration was longest for the first TNF antagonist used (CD 25 months; UC 14 months), followed by the second (CD 13 months; UC 4 months) and third TNF antagonist (CD 11 months; UC 15 months). Primary nonresponse, loss of response and side effects were the major reasons to stop and/or switch TNF antagonist therapy. A low body mass index, a short diagnostic delay and extraintestinal manifestations at inclusion were identified as risk factors for a switch of the first used TNF antagonist within 24 months of its use in CD patients.

CONCLUSION

Switching of the TNF antagonist over time is a common issue. The median treatment duration with a specific TNF antagonist is diminishing with an increasing number of TNF antagonists being used.

Item Type:	Journal Article (Original Article)
Division/Institute:	04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Gastroenterology 04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine > Paediatric Gastroenterology 04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM) 04 Faculty of Medicine > Service Sector > Institute of Pathology
UniBE Contributor:	Safroneeva, Ekaterina, Schöpfer, Alain, Juillerat, Pascal
Subjects:	600 Technology > 610 Medicine & health
ISSN:	0036-5521
Publisher:	Informa Healthcare
Language:	English
Submitter:	Anette van Dorland
Date Deposited:	18 Mar 2015 16:04
Last Modified:	05 Dec 2022 14:44
Publisher DOI:	10.3109/00365521.2014.946082
PubMed ID:	25120029
Additional Information:	Christoph Müller (Institute of Pathology) ist Member of the Swiss Inflammatory Bowel Diseases Cohort Study Group
Uncontrolled Keywords:	Crohn’s disease, drug switch, loss of response, side effects, tumor necrosis factor, tumor necrosis factor antagonist, ulcerative colitis
URI:	https://boris.unibe.ch/id/eprint/65295