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

UniBE Contributor:

Safroneeva, Ekaterina; Schöpfer, Alain and Juillerat, Pascal

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0036-5521

Publisher:

Informa Healthcare

Language:

English

Submitter:

André Schaller

Date Deposited:

18 Mar 2015 16:04

Last Modified:

29 Oct 2015 10:16

Publisher DOI:

10.3109/00365521.2014.946082

PubMed ID:

25120029

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

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