Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jul 13;3(4):otab049.
doi: 10.1093/crocol/otab049. eCollection 2021 Oct.

Adalimumab, Infliximab, and Vedolizumab in Treatment of Ulcerative Colitis: A Long-Term Retrospective Study in a Tertiary Referral Center

Ann-Lorie Gagnon  1 , William Beauchesne  1   2 , Laurence Tessier  1 , Charles David  1 , Djamal Berbiche  3 , Alexandre Lavoie  4 , Alban Michaud-Herbst  5 , Karine Tremblay  1   2
Affiliations

Adalimumab, Infliximab, and Vedolizumab in Treatment of Ulcerative Colitis: A Long-Term Retrospective Study in a Tertiary Referral Center

Ann-Lorie Gagnon et al. Crohns Colitis 360. .

Abstract

Background: Biological therapies have changed the landscape of pharmacological management of ulcerative colitis (UC). However, a large proportion of patients do not respond to biologics, lose their response over time, or present adverse drug events. This study aims to assess therapeutic response and treatment persistence to adalimumab, infliximab, and vedolizumab, 3 agents widely used in a tertiary referral center of Saguenay-Lac-Saint-Jean (Quebec, Canada).

Methods: We conducted a retrospective population-based study with a thorough review of patients' medical charts. Adults at UC diagnosis, with current or past use of adalimumab, infliximab, or vedolizumab, were included in the study. Clinical data were collected in order to assess response phenotypes and persistence to treatment. Kaplan-Meier curves were performed to assess treatment persistence, and predictors for discontinuation were assessed using Cox regression analyses.

Results: A total of 134 patients were included in this study. For the cases exposed to adalimumab, infliximab, and vedolizumab, 56.9%, 62.5%, and 47.5% were responders, respectively. Mean persistence rates (95% CI) were 5.5 (4.3-6.6), 10.1 (8.7-11.5), and 3.6 (2.9-4.2) years for adalimumab, infliximab, and vedolizumab, respectively. Increased persistence rates were observed in biologic-naïve patients treated with infliximab in comparison to those with the previous exposition to 2 biologics, but no such effect was observed for adalimumab or vedolizumab. Overall, 61.9% of cases had adverse drug events and of these, 6 led to treatment discontinuation.

Conclusion: This study presents long-term treatment persistence data with adalimumab, infliximab, and vedolizumab, showing that more than half of cases treated with these biologics remained on treatment at least 24 months after initiation.

Keywords: adalimumab; infliximab; population-based study; ulcerative colitis; vedolizumab.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Efficacy phenotypes distribution among ulcerative colitis subjects exposed to studied biologics. Circular graphs show the proportion of each response phenotype observed for adalimumab, infliximab, and vedolizumab.
Figure 2.
Figure 2.
Kaplan–Meier curves of treatment persistence of studied biologics. Each curve presents the cumulative persistence rate according to drug exposure duration (in years) for adalimumab (ADA), infliximab (IFX), and vedolizumab (VDZ).
See this image and copyright information in PMC

References

    1. Rubin DT, Ananthakrishnan AN, Siegel CA, et al. . ACG clinical guideline: ulcerative colitis in adults. Am J Gastroenterol. 2019;114(3):384–413. - PubMed
    1. Kornbluth A, Sachar DB; Practice Parameters Committee of the American College of Gastroenterology . Ulcerative colitis practice guidelines in adults: American College Of Gastroenterology, Practice Parameters Committee. Am J Gastroenterol. 2010;105(3):501–23; quiz 524. - PubMed
    1. Mao EJ, Hazlewood GS, Kaplan GG, et al. . Systematic review with meta-analysis: comparative efficacy of immunosuppressants and biologics for reducing hospitalisation and surgery in Crohn’s disease and ulcerative colitis. Aliment Pharmacol Ther. 2017;45(1):3–13. - PubMed
    1. Papamichael K, Gils A, Rutgeerts P, et al. . Role for therapeutic drug monitoring during induction therapy with TNF antagonists in IBD: evolution in the definition and management of primary nonresponse. Inflamm Bowel Dis. 2015;21(1):182–197. - PubMed
    1. Roda G, Jharap B, Neeraj N, Colombel JF.. Loss of response to anti-TNFs: definition, epidemiology, and management. Clin Transl Gastroenterol. 2016;7(1):e135. - PMC - PubMed

LinkOut - more resources