Vedolizumab vs. Ustekinumab as second-line therapy in Crohn's disease in clinical practice
The result's identifiers
Result code in IS VaVaI
<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00064165%3A_____%2F19%3A10394626" target="_blank" >RIV/00064165:_____/19:10394626 - isvavai.cz</a>
Alternative codes found
RIV/00216208:11110/19:10394626 RIV/00064203:_____/19:10394626
Result on the web
<a href="https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=ubQwTcpBm6" target="_blank" >https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=ubQwTcpBm6</a>
DOI - Digital Object Identifier
<a href="http://dx.doi.org/10.14735/AMGH201925" target="_blank" >10.14735/AMGH201925</a>
Alternative languages
Result language
angličtina
Original language name
Vedolizumab vs. Ustekinumab as second-line therapy in Crohn's disease in clinical practice
Original language description
Background: Vedolizumab (VDZ) and ustekinumab (UST) have become available for the treatment of Crohn's disease (CD), however, due to limited clinical experience, the optimal treatment strategy after a failure of anti-tumor necrosis factor (anti-TNF) has yet to be elucidated. In our study, we aim to evaluate the efciency and safety of VDZ and UST as second-line classes of biological therapy in a head-to-head manner in comparable populations of CD patients. Methods: Consecutive patients with CD who have previously been treated with anti-TNF therapy were included. Patients were followed at regular intervals coincident with drug applications and clinical activity (HBI - Harvey-Bradshaw Index), inflammatory markers (C-reactive protein, fecal calprotectin) and adverse events were recorded. The primary outcome was the proportion of patients in clinical remission in weeks 30-32 (HBI <= 4), the clinical response in terms of HBI decrease, and the withdrawal rate. Results: Forty-five patients with VDZ and 50 with UST were included. Both groups were comparable in all the evaluated parameters with the exception of the male-to-female ratio and the proportion of patients with penetrating disease phenotype. The proportion of patients in clinical remission increased from 44.4% at baseline to 58.1% in weeks 30-32 in the VDZ group and from 55.1% to 63.2% in the UST group; however, the increase was not statistically significant. The mean paired HBI diference between weeks 30-32 and baseline reached -1.94 +- 5.14 (p = 0.05) in the VDZ cohort and -2.94 +- 5.91 (p = 0.01) in the UST cohort. The proportion of patients in steroid-free clinical remission increased from 38.8% to 62.5% in the UST cohort (p = 0.04), and from 33.3% to 45.2% in the VDZ (p = 0.67). Six patients on VDZ and none on UST discontinued the treatment. Conclusion: Our study demonstrated a comparable efcacy of VDZ and UST with respect to the rate of clinical remission and biomarker response; however, the steroid-sparing efect of UST was more prominent. There is a need for prospective randomized head-to-head trials to assess the optimal position of new biological agents in the treatment of patients with CD.
Czech name
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Czech description
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Classification
Type
J<sub>SC</sub> - Article in a specialist periodical, which is included in the SCOPUS database
CEP classification
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OECD FORD branch
30219 - Gastroenterology and hepatology
Result continuities
Project
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Continuities
V - Vyzkumna aktivita podporovana z jinych verejnych zdroju
Others
Publication year
2019
Confidentiality
S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů
Data specific for result type
Name of the periodical
Gastroenterologie a hepatologie
ISSN
1804-7874
e-ISSN
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Volume of the periodical
73
Issue of the periodical within the volume
1
Country of publishing house
CZ - CZECH REPUBLIC
Number of pages
7
Pages from-to
25-31
UT code for WoS article
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EID of the result in the Scopus database
2-s2.0-85065516808