التفاصيل البيبلوغرافية
| العنوان: |
An Objective Comparison of Vedolizumab and Ustekinumab Effectiveness in Crohn's Disease Patients' Failure to TNF-Alpha Inhibitors. |
| المؤلفون: |
Onali, Sara1,2 (AUTHOR) sara.onali@unica.it, Pugliese, Daniela3 (AUTHOR) danipug@libero.it, Caprioli, Flavio Andrea4,5 (AUTHOR) flavio.caprioli@unimi.it, Orlando, Ambrogio6 (AUTHOR) ambrogiorlando@gmail.com, Biancone, Livia7 (AUTHOR) biancone@med.uniroma2.it, Nardone, Olga Maria8 (AUTHOR) olga.nardone@libero.it, Imperatore, Nicola9 (AUTHOR) nicola.imperatore@alice.it, Fiorino, Gionata10 (AUTHOR) gionataf@gmail.com, Cappello, Maria11 (AUTHOR) marica.cappello61@gmail.com, Viola, Anna12 (AUTHOR) annaviola88@gmail.com, Principi, Maria Beatrice13 (AUTHOR) b.principi@gmail.com, Bezzio, Cristina14 (AUTHOR) bezzioc@gmail.com, Aratari, Annalisa15 (AUTHOR) annalisa.aratari@gmail.com, Carparelli, Sonia16 (AUTHOR) carparelli.sonia@gmail.com, Mazzuoli, Silvia17 (AUTHOR) smazzuoli@libero.it, Manguso, Francesco9 (AUTHOR) manguso@alice.it, Grossi, Laurino18 (AUTHOR) rinogrossi62@gmail.com, Bodini, Giorgia19 (AUTHOR) bodini.giorgia@gmail.com, Ribaldone, Davide20 (AUTHOR) davrib_1998@yahoo.com, Mocci, Giammarco21 (AUTHOR) giammarco.mocci@gmail.com |
| المصدر: |
American Journal of Gastroenterology (Lippincott Williams & Wilkins). Aug2022, Vol. 117 Issue 8, p1279-1287. 9p. |
| مصطلحات موضوعية: |
*CROHN'S disease, *TUMOR necrosis factors, *VEDOLIZUMAB, *DISEASE remission, *COMPUTED tomography, *SMALL intestine |
| مستخلص: |
INTRODUCTION: The use of ustekinumab and vedolizumab as second-line therapies in patients with Crohn's disease (CD) in which tumour necrosis factor alpha inhibitors (TNFi) failed is still debated. The aim of this study was to compare, in a large multicenter observational retrospective cohort, the effectiveness of ustekinumab and vedolizumab as second-line therapies, as assessed by clinical and objective outcomes including endoscopy and gastrointestinal imaging. METHODS: Clinical response, remission, and steroid-free remission at weeks 26 and 52 were evaluated in a retrospective propensity score–weighted and propensity score–matched cohort of patients in which TNFi failed. Objective response and remission were evaluated by 1 or more techniques among endoscopy, magnetic resonance/computed tomography enteroclysis, and small bowel ultrasound. RESULTS: A total of 470 patients with CD (239 treated with ustekinumab and 231 treated with vedolizumab) were included in the study. At week 26, clinical outcomes were similar between the 2 groups. At week 52, clinical remission (ustekinumab 42.5% vs vedolizumab 55.5%, P = 0.01) and steroid-free remission (ustekinumab 40.6% vs vedolizumab 51.1%, P = 0.038) rates were significantly higher in vedolizumab-treated patients. Three hundred two patients (hundred thirty-five treated with ustekinumab and hundred sixty-seven treated with vedolizumab) had an objective evaluation of disease activity at baseline and week 52. At week 52, objective response and remission rates were similar between the 2 groups. Clinical response at week 26 predicted steroid-free remission at week 52 in both ustekinumab-treated and vedolizumab-treated patients. Safety profiles were similar between the 2 groups. DISCUSSION: In patients with CD in which TNFi failed, both ustekinumab and vedolizumab showed similar clinical effectiveness after 26 weeks of treatment. At 1 year, vedolizumab was associated with a higher rate of clinical remission when compared with ustekinumab. However, no difference was observed between the 2 groups when objective outcomes were investigated at this time point. [ABSTRACT FROM AUTHOR] |
| قاعدة البيانات: |
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