Risk of hospitalisation and surgery linked to IBD biological

A comparative analysis of biological therapies used in the treatment of inflammatory bowel disease (IBD) revealed that users of adalimumab as a first-line therapy for Crohn’s disease (CD) were at higher risk of hospitalisation than users of infliximab. Moreover, vedolizumab as a second-line therapy for ulcerative colitis (UC) was associated with an increased risk of IBD-related surgery. Future studies should assess whether these results reflect drug efficacy and safety differences, or differences in disease state at the start of treatment.

A Danish, nationwide cohort study compared biologic treatments for CD and UC [1]. Between 2015 and 2018, bio-naïve patients (n=3,722) starting a treatment with infliximab, adalimumab, vedolizumab, golimumab, or ustekinumab were enrolled. The analysis was adjusted for health-related and socio-economic factors at baseline.

Infliximab was the prescribed first-line treatment in >90% of the patients. In addition, patients treated with infliximab were younger at the start of treatment than users of other biologics. On average, infliximab recipients were more often males, had a lower level of education, and were less likely to have been exposed to IBD surgery than users of other biological therapies. CD patients receiving adalimumab as a first-line treatment had a higher risk of all-cause hospitalisation than users of infliximab (HR 1.56; 95% CI 1.16-2.10). However, adalimumab- and infliximab treated patients did not differ on IBD hospitalisation, IBD-related surgery, or the use of corticosteroids. In comparison with adalimumab, second-line treatment with vedolizumab was associated with an increased risk of IBD-related surgery among UC patients (HR 1.94; 95% CI 1.01-3.71).

1. Bjørn Jensen C, et al. Patient characteristics and adverse effects in biologic treatment of Crohn’s Disease and Ulcerative Colitis: A nationwide Danish cohort study 2015-2018. P603, ECCO 2021 Virtual Congress, 2-3 & 8-10 July.

 

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Posted on 2 July 20218 April 2024