Persistence of Second and Third-Line Biologics in Inflammatory Bowel Disease: A Multi-Centre Cohort Study
Background: Despite proven efficacy of biologics in inflammatory bowel disease (IBD), many exhibit primary non-response or secondary loss of response and switch to subsequent biologic(s). Here, we identified early predictors of second- and/or third-line biologic persistence in IBD, in a real-world c...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-12-01
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| Series: | Future Pharmacology |
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| Online Access: | https://www.mdpi.com/2673-9879/2/4/41 |
| _version_ | 1797458172680601600 |
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| author | Timothy P. Hanrahan Robbie Chan Daniel Tassone Nik S. Ding Chamara Basnayake Julien Schulberg Abhinav Vasudevan Michael Kamm Michael De Gregorio Daniel R. van Langenberg Ola Niewiadomski |
| author_facet | Timothy P. Hanrahan Robbie Chan Daniel Tassone Nik S. Ding Chamara Basnayake Julien Schulberg Abhinav Vasudevan Michael Kamm Michael De Gregorio Daniel R. van Langenberg Ola Niewiadomski |
| author_sort | Timothy P. Hanrahan |
| collection | DOAJ |
| description | Background: Despite proven efficacy of biologics in inflammatory bowel disease (IBD), many exhibit primary non-response or secondary loss of response and switch to subsequent biologic(s). Here, we identified early predictors of second- and/or third-line biologic persistence in IBD, in a real-world cohort of patients. Methods: A retrospective multicentre cohort study was conducted on patients receiving second- and/or third-line biologics for IBD from 2005–2021. Cox regression was applied to identify factors predictive of longer cumulative biologic persistence prior to treatment failure. Results: Of 179 patients who received ≥2 biologics, 159 (88.8%) received an anti-tumour necrosis factor (anti-TNF) first-line. There was a significantly increased likelihood of longer treatment persistence in recipients who received an anti-TNF first, versus those that received a non-anti-TNF agent first (<i>p</i> < 0.01). A diagnosis of CD (OR 7.1, 95% CI [2.3–21.7], <i>p</i> < 0.01), and endoscopic remission achieved on the first biologic (OR 10.4 [1.3–79.9], <i>p</i> = 0.03) were positive predictors of longer biologic persistence, whilst advancing age at IBD diagnosis (OR 0.97 [0.94–0.99], <i>p</i> = 0.04) and primary non-response to initial biologic (OR 0.3 [0.1–0.7], <i>p</i> < 0.01) were inversely associated with biologic persistence. Conclusions: These real-world data demonstrate multiple, simple to identify factors that offer the potential for early objectively assessed response to first-line biologic to predict future biologic persistence. |
| first_indexed | 2024-03-09T16:33:15Z |
| format | Article |
| id | doaj.art-5a298431f5a84a679f3e58eebe975873 |
| institution | Directory Open Access Journal |
| issn | 2673-9879 |
| language | English |
| last_indexed | 2024-03-09T16:33:15Z |
| publishDate | 2022-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Future Pharmacology |
| spelling | doaj.art-5a298431f5a84a679f3e58eebe9758732023-11-24T14:59:13ZengMDPI AGFuture Pharmacology2673-98792022-12-012466968010.3390/futurepharmacol2040041Persistence of Second and Third-Line Biologics in Inflammatory Bowel Disease: A Multi-Centre Cohort StudyTimothy P. Hanrahan0Robbie Chan1Daniel Tassone2Nik S. Ding3Chamara Basnayake4Julien Schulberg5Abhinav Vasudevan6Michael Kamm7Michael De Gregorio8Daniel R. van Langenberg9Ola Niewiadomski10Department of Gastroenterology, Eastern Health, Melbourne, VIC 3128, AustraliaDepartment of Gastroenterology, Eastern Health, Melbourne, VIC 3128, AustraliaDepartment of Gastroenterology, St. Vincent’s Hospital, Melbourne, VIC 3065, AustraliaDepartment of Gastroenterology, St. Vincent’s Hospital, Melbourne, VIC 3065, AustraliaDepartment of Gastroenterology, St. Vincent’s Hospital, Melbourne, VIC 3065, AustraliaDepartment of Gastroenterology, St. Vincent’s Hospital, Melbourne, VIC 3065, AustraliaDepartment of Gastroenterology, Eastern Health, Melbourne, VIC 3128, AustraliaDepartment of Gastroenterology, St. Vincent’s Hospital, Melbourne, VIC 3065, AustraliaDepartment of Gastroenterology, St. Vincent’s Hospital, Melbourne, VIC 3065, AustraliaDepartment of Gastroenterology, Eastern Health, Melbourne, VIC 3128, AustraliaDepartment of Gastroenterology, Eastern Health, Melbourne, VIC 3128, AustraliaBackground: Despite proven efficacy of biologics in inflammatory bowel disease (IBD), many exhibit primary non-response or secondary loss of response and switch to subsequent biologic(s). Here, we identified early predictors of second- and/or third-line biologic persistence in IBD, in a real-world cohort of patients. Methods: A retrospective multicentre cohort study was conducted on patients receiving second- and/or third-line biologics for IBD from 2005–2021. Cox regression was applied to identify factors predictive of longer cumulative biologic persistence prior to treatment failure. Results: Of 179 patients who received ≥2 biologics, 159 (88.8%) received an anti-tumour necrosis factor (anti-TNF) first-line. There was a significantly increased likelihood of longer treatment persistence in recipients who received an anti-TNF first, versus those that received a non-anti-TNF agent first (<i>p</i> < 0.01). A diagnosis of CD (OR 7.1, 95% CI [2.3–21.7], <i>p</i> < 0.01), and endoscopic remission achieved on the first biologic (OR 10.4 [1.3–79.9], <i>p</i> = 0.03) were positive predictors of longer biologic persistence, whilst advancing age at IBD diagnosis (OR 0.97 [0.94–0.99], <i>p</i> = 0.04) and primary non-response to initial biologic (OR 0.3 [0.1–0.7], <i>p</i> < 0.01) were inversely associated with biologic persistence. Conclusions: These real-world data demonstrate multiple, simple to identify factors that offer the potential for early objectively assessed response to first-line biologic to predict future biologic persistence.https://www.mdpi.com/2673-9879/2/4/41Crohn’s diseaseulcerative colitisinfliximabbiologicspersistence |
| spellingShingle | Timothy P. Hanrahan Robbie Chan Daniel Tassone Nik S. Ding Chamara Basnayake Julien Schulberg Abhinav Vasudevan Michael Kamm Michael De Gregorio Daniel R. van Langenberg Ola Niewiadomski Persistence of Second and Third-Line Biologics in Inflammatory Bowel Disease: A Multi-Centre Cohort Study Future Pharmacology Crohn’s disease ulcerative colitis infliximab biologics persistence |
| title | Persistence of Second and Third-Line Biologics in Inflammatory Bowel Disease: A Multi-Centre Cohort Study |
| title_full | Persistence of Second and Third-Line Biologics in Inflammatory Bowel Disease: A Multi-Centre Cohort Study |
| title_fullStr | Persistence of Second and Third-Line Biologics in Inflammatory Bowel Disease: A Multi-Centre Cohort Study |
| title_full_unstemmed | Persistence of Second and Third-Line Biologics in Inflammatory Bowel Disease: A Multi-Centre Cohort Study |
| title_short | Persistence of Second and Third-Line Biologics in Inflammatory Bowel Disease: A Multi-Centre Cohort Study |
| title_sort | persistence of second and third line biologics in inflammatory bowel disease a multi centre cohort study |
| topic | Crohn’s disease ulcerative colitis infliximab biologics persistence |
| url | https://www.mdpi.com/2673-9879/2/4/41 |
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