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The Use and Efficacy of Biological Therapies for Inflammatory Bowel Disease in a Danish Tertiary Centre 2010–2020

BACKGROUND: Patients with inflammatory bowel disease (IBD) who receive biologicals frequently experience lack or loss of response. Our aim was to describe the use and efficacy of biological therapy in a tertiary IBD center. METHODS: We included all bio-naive IBD patients who initiated biological the...

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Autores principales: Wewer, Mads Damsgaard, Arp, Laura, Sarikaya, Melek, Felding, Oluf Krautwald, Vind, Ida, Pedersen, Gitte, Mertz-Nielsen, Anette, Kiszka-Kanowitz, Marianne, Boysen, Trine, Theede, Klaus, Petersen, Andreas Munk, Nordgaard-Lassen, Inge, Bendtsen, Flemming, Burisch, Johan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9802297/
https://www.ncbi.nlm.nih.gov/pubmed/36778517
http://dx.doi.org/10.1093/crocol/otac041
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author Wewer, Mads Damsgaard
Arp, Laura
Sarikaya, Melek
Felding, Oluf Krautwald
Vind, Ida
Pedersen, Gitte
Mertz-Nielsen, Anette
Kiszka-Kanowitz, Marianne
Boysen, Trine
Theede, Klaus
Petersen, Andreas Munk
Nordgaard-Lassen, Inge
Bendtsen, Flemming
Burisch, Johan
author_facet Wewer, Mads Damsgaard
Arp, Laura
Sarikaya, Melek
Felding, Oluf Krautwald
Vind, Ida
Pedersen, Gitte
Mertz-Nielsen, Anette
Kiszka-Kanowitz, Marianne
Boysen, Trine
Theede, Klaus
Petersen, Andreas Munk
Nordgaard-Lassen, Inge
Bendtsen, Flemming
Burisch, Johan
author_sort Wewer, Mads Damsgaard
collection PubMed
description BACKGROUND: Patients with inflammatory bowel disease (IBD) who receive biologicals frequently experience lack or loss of response. Our aim was to describe the use and efficacy of biological therapy in a tertiary IBD center. METHODS: We included all bio-naive IBD patients who initiated biological therapy between 2010 and 2020 at our centre. Their medical records were reviewed. RESULTS: The population consisted of 327 Crohn’s disease (CD) patients, 291 ulcerative colitis (UC) patients, and 3 patients with IBD unclassified (IBDU). The median follow-up was 3 years (interquartile range = 2–5) after initiating therapy. The annual number of patients initiating biological therapy rose from 29 (2010) to 85 (2019). Most patients (457, 73.6%) received 1 biological drug; 164 (26.4%) patients received 2 or more biologicals. Primary lack of response was observed in 36.4% (106/291) and 17.4% (57/327) of UC and CD patients; loss of response was observed in 27.1% (79/291) and 31.5% (103/327) of UC and CD patients, respectively. The 5-year surgery rates were 26.6% and 20.4% in UC and CD patients, respectively. Multivariate Cox regression showed that treatment with thiopurine reduced the likelihood of needing to switch biological therapy, requiring surgery or corticosteroids in UC patients (HR: 0.745, 95% CI: 0.559–0.993), but not in CD patients (HR: 0.996, 95% CI: 0.736–1.349). CONCLUSIONS: The annual number of IBD patients initiated on biological therapy increased considerably between 2010 and 2020. One-quarter of these patients required surgery after 5 years. Our findings suggest a beneficial effect of concurrent thiopurines for UC patients receiving biologicals, but this was not found for CD patients. This effect in UC patients was not observed when we included patients initiating thiopurines up to 6 months after the introduction of biological therapy.
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spelling pubmed-98022972023-02-10 The Use and Efficacy of Biological Therapies for Inflammatory Bowel Disease in a Danish Tertiary Centre 2010–2020 Wewer, Mads Damsgaard Arp, Laura Sarikaya, Melek Felding, Oluf Krautwald Vind, Ida Pedersen, Gitte Mertz-Nielsen, Anette Kiszka-Kanowitz, Marianne Boysen, Trine Theede, Klaus Petersen, Andreas Munk Nordgaard-Lassen, Inge Bendtsen, Flemming Burisch, Johan Crohns Colitis 360 Observations and Research BACKGROUND: Patients with inflammatory bowel disease (IBD) who receive biologicals frequently experience lack or loss of response. Our aim was to describe the use and efficacy of biological therapy in a tertiary IBD center. METHODS: We included all bio-naive IBD patients who initiated biological therapy between 2010 and 2020 at our centre. Their medical records were reviewed. RESULTS: The population consisted of 327 Crohn’s disease (CD) patients, 291 ulcerative colitis (UC) patients, and 3 patients with IBD unclassified (IBDU). The median follow-up was 3 years (interquartile range = 2–5) after initiating therapy. The annual number of patients initiating biological therapy rose from 29 (2010) to 85 (2019). Most patients (457, 73.6%) received 1 biological drug; 164 (26.4%) patients received 2 or more biologicals. Primary lack of response was observed in 36.4% (106/291) and 17.4% (57/327) of UC and CD patients; loss of response was observed in 27.1% (79/291) and 31.5% (103/327) of UC and CD patients, respectively. The 5-year surgery rates were 26.6% and 20.4% in UC and CD patients, respectively. Multivariate Cox regression showed that treatment with thiopurine reduced the likelihood of needing to switch biological therapy, requiring surgery or corticosteroids in UC patients (HR: 0.745, 95% CI: 0.559–0.993), but not in CD patients (HR: 0.996, 95% CI: 0.736–1.349). CONCLUSIONS: The annual number of IBD patients initiated on biological therapy increased considerably between 2010 and 2020. One-quarter of these patients required surgery after 5 years. Our findings suggest a beneficial effect of concurrent thiopurines for UC patients receiving biologicals, but this was not found for CD patients. This effect in UC patients was not observed when we included patients initiating thiopurines up to 6 months after the introduction of biological therapy. Oxford University Press 2022-11-03 /pmc/articles/PMC9802297/ /pubmed/36778517 http://dx.doi.org/10.1093/crocol/otac041 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of Crohn's & Colitis Foundation. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Observations and Research
Wewer, Mads Damsgaard
Arp, Laura
Sarikaya, Melek
Felding, Oluf Krautwald
Vind, Ida
Pedersen, Gitte
Mertz-Nielsen, Anette
Kiszka-Kanowitz, Marianne
Boysen, Trine
Theede, Klaus
Petersen, Andreas Munk
Nordgaard-Lassen, Inge
Bendtsen, Flemming
Burisch, Johan
The Use and Efficacy of Biological Therapies for Inflammatory Bowel Disease in a Danish Tertiary Centre 2010–2020
title The Use and Efficacy of Biological Therapies for Inflammatory Bowel Disease in a Danish Tertiary Centre 2010–2020
title_full The Use and Efficacy of Biological Therapies for Inflammatory Bowel Disease in a Danish Tertiary Centre 2010–2020
title_fullStr The Use and Efficacy of Biological Therapies for Inflammatory Bowel Disease in a Danish Tertiary Centre 2010–2020
title_full_unstemmed The Use and Efficacy of Biological Therapies for Inflammatory Bowel Disease in a Danish Tertiary Centre 2010–2020
title_short The Use and Efficacy of Biological Therapies for Inflammatory Bowel Disease in a Danish Tertiary Centre 2010–2020
title_sort use and efficacy of biological therapies for inflammatory bowel disease in a danish tertiary centre 2010–2020
topic Observations and Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9802297/
https://www.ncbi.nlm.nih.gov/pubmed/36778517
http://dx.doi.org/10.1093/crocol/otac041
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