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, three agents widely used in a tertiary referral centre of Saguenay-Lac-Saint-Jean (Quebec, Canada).
Methods
We conducted a retrospective population-based study with a thorough review of patient’s 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. Median persistence rates (95% CI) were 8.0 (3.3-12.8), 13.4 (9.3-17.5) and 3.4 (1.0-5.8) years for adalimumab, infliximab and vedolizumab, respectively. Increased persistence rates were observed in biologic-naïve in comparison to biologic-experienced patients treated with infliximab, but no such effect was observed for adalimumab or vedolizumab. Overall, 61.9% of cases had adverse drug events and of these, six lead 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 12 months after initiation.
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