The effectiveness of second- and-third-line biologics in perianal Crohn's disease—a multicenter propensity score-matched study

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00098892%3A_____%2F25%3A10159358" target="_blank" >RIV/00098892:_____/25:10159358 - isvavai.cz</a>

Alternative codes found

RIV/00216208:11110/25:10500007 RIV/61989592:15110/25:73631543

Result on the web

<a href="https://academic.oup.com/ecco-jcc/article/19/6/jjaf099/8159162?login=true" target="_blank" >https://academic.oup.com/ecco-jcc/article/19/6/jjaf099/8159162?login=true</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1093/ecco-jcc/jjaf099" target="_blank" >10.1093/ecco-jcc/jjaf099</a>

Result language

angličtina

Original language name

The effectiveness of second- and-third-line biologics in perianal Crohn's disease—a multicenter propensity score-matched study

Original language description

Background and Aims: Anti-tumor necrosis factor- inhibitors (anti-TNFs) are the established treatment for perianal Crohn&apos;s disease (pCD), but relapse and non-response are common. Data on second- and third-line biologics are limited. We present the first direct comparison of second- and third-line biologics in pCD patients with active perianal disease previously treated with first-line anti-TNFs. Methods: A multicenter retrospective cohort study included adult patients with pCD who failed first-line anti-TNF. The primary outcome was clinical perianal response, with secondary outcomes of radiological response (magnetic resonance imaging or transrectal ultrasound) and healing, and clinical remission. Propensity score matching (PSM) was used to adjust for baseline differences. Results: A total of 486 pCD patients from 23 IBD centers were included, with 333/486 (68.5%) and 216/263 (82.1%) matched by PSM in the second and third-line treatment groups, respectively. In the second-line group, 62/78 (79.5%) of ustekinumab (UST)-treated patients achieved clinical perianal response, compared to 46/78 (58.9%) with vedolizumab (VDZ) (OR 4.47, 95% CI, 1.94-10.28, P &lt; .001) and 38/78 (48.7%) with anti-TNFs (OR 5.29, 95% CI, 2.39-11.71, P &lt; .001). In the third-line group, 38/49 (77.6%) of UST-treated patients achieved clinical perianal response, compared to 29/49 (59.2%) with VDZ (OR 9.96, 95% CI, 2.6-38.4, P &lt; .001) and 27/49 (55.1%) with anti-TNFs (OR 12.03, 95% CI, 2.99-48.47, P &lt; .001). UST-treated patients also had higher radiological response rates than VDZ (OR 3.28, 95% CI, 1.07-10.07, P = .038). Conclusion: In pCD patients failing anti-TNFs as first-line treatment, ustekinumab may be more effective than vedolizumab or another anti-TNF as second or third-line therapy.

Czech name

—

Czech description

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Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

—

OECD FORD branch

30219 - Gastroenterology and hepatology

Project

—

Continuities

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Publication year

2025

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

Journal of Crohn&apos;s and Colitis

ISSN

1873-9946

e-ISSN

1876-4479

Volume of the periodical

19

Issue of the periodical within the volume

6

Country of publishing house

GB - UNITED KINGDOM

Number of pages

14

Pages from-to

"jjaf099"

UT code for WoS article

001518392100001

EID of the result in the Scopus database

2-s2.0-105009849815