Lenti, Marco Vincenzo, Dolby, Vivien, Clark, Tanya, Hall, Veronica, Tattersall, Suzanne, Fairhurst, Francesca, Kenneth, Catherine, Walker, Rachael, Kemp, Karen, Borg-Bartolo, Simon et al (show 11 more authors)
(2022)
A propensity score-matched, real-world comparison of ustekinumab vs vedolizumab as a second-line treatment for Crohn's disease. The Cross Pennine study II.
ALIMENTARY PHARMACOLOGY & THERAPEUTICS, 55 (7).
pp. 856-866.
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A propensity score-matched, real-world comparison of ustekinumab vs vedolizumab as a second-line treatment for Crohns diseas.pdf - Open Access published version Download (595kB) | Preview |
Abstract
<h4>Background</h4>The optimal choice of biological agents after failure of anti-tumour-necrosis-factor-(TNF)α agent in Crohn's disease (CD) is yet to be defined.<h4>Aims</h4>To assess the effectiveness and safety of ustekinumab compared to vedolizumab as second-line treatment in CD patients who failed anti-TNFα therapy.<h4>Methods</h4>Retrospective analysis of clinical response and remission at 14 and 52 weeks to ustekinumab by physician global assessment (PGA). A propensity score-matched analysis with a cohort treated with vedolizumab was performed.<h4>Results</h4>Of 282 patients (mean age 40 ± 15, F:M ratio 1.7:1) treated with ustekinumab, clinical response or remission was reached by 200/282 patients (70.9%) at 14 weeks, and 162/259 patients (62.5%) at 52 weeks. Overall, 74 adverse events occurred, of which 26 were labelled as serious (8.3 per 100 person-year). After exclusion of patients without prior anti-TNFα exposure and patients previously exposed to vedolizumab or ustekinumab, we analysed 275/282 patients (97.5%) on ustekinumab and 118/135 patients (87.4%) on vedolizumab. Propensity score analysis revealed that at 14 weeks, patients treated with ustekinumab were 38% (95% CI 25%-50%; P < 0.001) more likely to achieve clinical remission, while at 52 weeks, the difference of 9% (95% CI -15% to 33%; P = 0.462) was not significant.<h4>Conclusions</h4>Ustekinumab was effective and well tolerated in this real-world cohort. While ustekinumab proved more effective at 14-weeks, we found no statistically significant differences at 52 weeks compared to vedolizumab.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | Humans, Crohn Disease, Treatment Outcome, Remission Induction, Retrospective Studies, Adult, Middle Aged, Propensity Score, Antibodies, Monoclonal, Humanized, Ustekinumab |
| Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Population Health Faculty of Health and Life Sciences > Institute of Population Health > School of Health Sciences |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 07 Aug 2023 07:26 |
| Last Modified: | 07 Aug 2023 07:26 |
| DOI: | 10.1111/apt.16742 |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3172064 |
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