Comparative Analysis of the 3-Year Persistence Rate with Second-Line Vedolizumab and Tumor Necrosis Factor-α Inhibitors in Patients with Inflammatory Bowel Disease Followed in Gastroenterology Practices in Germany

Helwig, Ulf; Braegger, F; Kostev, Karel; Schmidt, Carsten

doi:10.1159/000506121

Cited by 9 publications

(4 citation statements)

References 21 publications

(29 reference statements)

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“…Two recent German studies reported that vedolizumab was associated with better treatment persistence, both as first and second line agent, compared with anti-TNFα agents. 105 , 106 Such findings are in contrast with the results of the VICTORY consortium, where anti-TNF agents were reported to have better persistence compared with vedolizumab in CD patients. 107 Considering that IBD are life-long conditions that usually arise in young adults, 108 further investigations on the best strategies to maintain long-term remission are needed.…”

Section: Combination and Sequential Therapies For A Dynamic Management Of Ibdcontrasting

confidence: 69%

Novel trends with biologics in inflammatory bowel disease: sequential and combined approaches

Privitera

Pugliese

Lopetuso

et al. 2021

Therap Adv Gastroenterol

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Inflammatory bowel disease (IBD) management has changed dramatically over the past 20 years, after the introduction of targeted biological therapies. However, the impact of these new drugs in changing the natural history of disease is still under debate. Recent evidence seems to suggest that the extent of their efficacy might be, at least partially, dependent on the timing of their introduction and on the subsequent management strategy. In this complex landscape, the potential role for a more dynamic approach with treatments based on sequencing and combining targeted therapies has been explored only minimally so far. In this review, we aim to explore the potential biological rationale behind the use of sequential and combination therapies in IBD, to summarise the current knowledge on this topic and to propose a management algorithm that combines these notions.

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Section: Combination and Sequential Therapies For A Dynamic Management Of Ibdcontrasting

confidence: 69%

Novel trends with biologics in inflammatory bowel disease: sequential and combined approaches

Privitera

Pugliese

Lopetuso

et al. 2021

Therap Adv Gastroenterol

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“…Helwig et al [78] evaluated more than 5000 patients who had received prescriptions for second-line biologic drugs in Germany between 2014 and 2017. Vedolizumab users were matched to adalimumab, golimumab, and infliximab users based on age, sex, and index year.…”

Section: Comparison Between Anti-tnf and Vedolizumab Treatment In Anti-tnf Experienced Patientsmentioning

confidence: 99%

Primary Failure to an Anti-TNF Agent in Inflammatory Bowel Disease: Switch (to a Second Anti-TNF Agent) or Swap (for Another Mechanism of Action)?

Gisbert

Chaparro

2021

JCM

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Background: About a third of patients with inflammatory bowel disease do not respond to anti-tumour necrosis factor (anti-TNF) therapy, which is challenging. Aim: To review the current data on the two main strategies when facing primary non-response to an anti-TNF agent in inflammatory bowel disease: changing to a second anti-TNF (switching) or to a drug with another mechanisms of action (swapping). Methods: We performed a bibliographic search to identify studies reporting on efficacy of any biologic treatment after primary anti-TNF non-response. Results: The efficacy of a second anti-TNF is lower when the reason to withdraw the first one is primary failure. Nevertheless, switching to another anti-TNF even after primary failure may still be effective in some patients. Both vedolizumab and ustekinumab have generally been shown to be less effective in anti-TNF exposed patients. However, despite primary anti-TNF failure, patients may respond to vedolizumab or ustekinumab in a limited but considerable number of cases. The cause for swapping (primary vs. secondary anti-TNF failure) seems to have limited effect on vedolizumab efficacy. Primary anti-TNF non-response seems to be a clearer predictor of treatment failure for ustekinumab. Unfortunately, the two main strategies to treat specifically a patient with primary non-response to an anti-TNF agent—switching to a second anti-TNF or swapping for vedolizumab/ustekinumab—have not been properly compared. Conclusion: The data reviewed in the present study clearly emphasise the imperative need to carry out head-to-head randomised trials in patients exposed to anti-TNF agents in general, and specifically in those with primary non-response to these agents.

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“… 27–29 The results of Chen et al’s study 27 were used as a source of persistence data for infliximab and adalimumab in the first line of treatment. Helwig et al’s studies 28 , 29 were used as a data source for vedolizumab in the first line of treatment and all biologic treatments in the subsequent lines. Because persistence at year 1 in the base case was based on the 1-year maintenance data from clinical studies, long-term persistence rate was recalculated using real-world studies with 1 year as the starting point.…”

Section: Methodsmentioning

confidence: 99%

Cost-effectiveness Analysis of Subcutaneous Infliximab for Inflammatory Bowel Diseases in Sequential Biologic Treatment

Bouhnik

Atreya

Casey³

et al. 2022

Inflammatory Bowel Diseases

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Background Inflammatory bowel disease (IBD) guidelines recommend tumor necrosis factor-α inhibitors (TNFis) for patients who have not responded to conventional therapy, and vedolizumab in case of inadequate response to conventional therapy and/or TNFis. Recent studies have shown that vedolizumab may also be effective in the earlier treatment lines. Therefore, we conducted cost-effectiveness analyses to determine the optimal treatment sequence in patients with IBD. Methods A Markov model with a 10-year time horizon compared the cost-effectiveness of different biologic treatment sequences in patients with moderate to severe ulcerative colitis (UC) and Crohn’s disease (CD) from the UK and French perspectives. Subcutaneous formulations of infliximab, vedolizumab, and adalimumab were evaluated. Comparative effectiveness was based on a network meta-analysis of clinical trials and real-world evidence. Costs included pharmacotherapy, surgery, adverse events, and disease management. Results The results indicated that treatment sequences starting with infliximab were less costly and more effective than those starting with vedolizumab for patients with UC in the United Kingdom and France, and patients with just CD in France. For patients with CD in the United Kingdom, treatment sequences starting with infliximab resulted in better health outcomes with incremental cost-effectiveness ratios (ICERs) near the threshold. Conclusions Based on the ICERs, treatment sequences starting with infliximab are the dominant option for patients with UC in the United Kingdom, and patients with UC and CD in France. In UK patients with CD, ICERs were near the assumed “willingness to pay” threshold. These results reinforce the UK’s National Institute for Health and Care Excellence recommendations for using infliximab prior to using vedolizumab in biologics-naïve patients.

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Comparative Analysis of the 3-Year Persistence Rate with Second-Line Vedolizumab and Tumor Necrosis Factor-α Inhibitors in Patients with Inflammatory Bowel Disease Followed in Gastroenterology Practices in Germany

Cited by 9 publications

References 21 publications

Novel trends with biologics in inflammatory bowel disease: sequential and combined approaches

Novel trends with biologics in inflammatory bowel disease: sequential and combined approaches

Primary Failure to an Anti-TNF Agent in Inflammatory Bowel Disease: Switch (to a Second Anti-TNF Agent) or Swap (for Another Mechanism of Action)?

Cost-effectiveness Analysis of Subcutaneous Infliximab for Inflammatory Bowel Diseases in Sequential Biologic Treatment

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