Epidemiological data and utilization patterns of anti-TNF alpha therapy in the Hungarian ulcerative colitis population between 2012-2016

Kunovszki, Péter; Szántó, K; Gimesi-Országh, Judit; Takács, Péter; Borsi, András; Bálint, Anita; Farkas, Klaudia; Milassin, Ágnes; Lakatos, László; Szamosi, Tamás; Molnár, Tamás

doi:10.1080/14712598.2020.1718097

Cited by 8 publications

(8 citation statements)

References 17 publications

(17 reference statements)

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“…It is interesting to note that, possibly, IFX preference for the management of UC may be related, at least in part, with the longer time to intensification with this anti-TNF α. In any case, the observed trends are aligned with those reported in a recent retrospective claims database study; treatment intensification was performed earlier for patients on ADA than for those on IFX [28] . The observed early need of treatment intensification with ADA in UC patients has important practical implications.…”

Section: Article In Presssupporting

confidence: 82%

Treatment patterns and intensification within 5 year of follow-up of the first-line anti-TNFα used for the treatment of IBD: Results from the VERNE study

Bastida¹,

Marín-Jiménez²,

Forés³

et al. 2022

Digestive and Liver Disease

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Background: Anti-TNF α represent one of the main treatment approaches for the management of inflammatory bowel diseases (IBD). Therefore,the evaluation of their treatment patterns over time provides valuable insights about the clinical value of therapies and associated costs. Aims:To assess the treatment patterns with the first anti-TNF α in IBD.Methods: Retrospective, observational study.Results: 310 IBD patients were analyzed along a 5-year follow-up period. 56.2% of Crohn's disease (CD) patients started with adalimumab (ADA), while 43.8% started with infliximab (IFX). 12.9% of ulcerative colitis (UC) patients initiated with ADA, while 87.1% initiated with IFX. Treatment intensification was required in 28.9% of CD and 37.1% of UC patients. Median time to treatment intensification was shorter in UC than in CD (5.3 vs. 14.3 months; p = 0.028). Treatment discontinuation due to reasons other than remission were observed in 40.7% of CD and 40.5% of UC patients, although, in UC patients there was a trend to lower discontinuation rates with IFX (36.6%) than with ADA (66.7%). Loss of response accounted for approximately one-third of discontinuations, in both CD and UC.Conclusions: Around one-third of IBD biologic-naive patients treated with an anti-TNF α required treatment intensification (earlier in UC) and around 40% discontinued the anti-TNF α due to inappropriate disease control.

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Section: Article In Presssupporting

confidence: 82%

Treatment patterns and intensification within 5 year of follow-up of the first-line anti-TNFα used for the treatment of IBD: Results from the VERNE study

Bastida¹,

Marín-Jiménez²,

Forés³

et al. 2022

Digestive and Liver Disease

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“…Ulcerative colitis (UC) is a chronic inflammatory disease of the colon caused by unbalanced immune responses to host intestinal microbiota and main threatens to public health ( Roselli and Finamore, 2019 ). Although much progress has been made in diagnosis ( Yang et al., 2019 ; Vadstrup et al., 2020 ) and therapy ( Karjalainen et al., 2020 ; Kunovszki et al., 2020 ) for UC in recent years, an effective therapeutic drug is still difficult to be available. Gut microbiota disturbance ( Noor et al., 2010 ) and intestinal barrier injury ( Chen et al., 2019 ) is often associated with a UC risk.…”

Section: Introductionmentioning

confidence: 99%

Kuijieyuan Decoction Improved Intestinal Barrier Injury of Ulcerative Colitis by Affecting TLR4-Dependent PI3K/AKT/NF-κB Oxidative and Inflammatory Signaling and Gut Microbiota

Liu

Piao²,

Niu

et al. 2020

Front. Pharmacol.

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Ethnopharmacological Relevance In Traditional Chinese medicine (TCM) theory, ulcerative colitis (UC) is associated with damp-heat, blood stasis, and intestinal vascular ischemia. Kuijieyuan decoction (KD) is a traditional Chinese medicine based on the above theory and used clinically to alleviate UC injury. Methods The main components of KD were analyzed by using high-pressure liquid chromatography (HPLC) and confirmed by UPLC-MS/MS. A UC model was established in rats by using dextran sulfate sodium (DSS) and dead rats (caused by DSS) were excluded from the study. Forty-eight rats were divided into 6 groups, health control (CG), UC model (UG), sulfasalazine (SG), low-dose KD (LG), middle-dose KD (MG), and high-dose KD (HG) groups. UC damage was assessed by hematoxylin and eosin staining and scan electron microscopy. We measured Toll-like receptor 4 (TLR4), p-phosphatidylinositol 3-kinase (PI3K), PI3K, p-Protein kinase B (AKT), AKT, p-nuclear factor kappa B (NF-κB), NF-κB, oxidative stress marker (superoxidase dismutase (SOD), catalase (CAT), glutathione peroxidases (GPx), and malondialdehyde) and inflammatory markers (tumor necrosis factor α (TNFα), interleukin (IL)-1, IL-6 and IL-10) in UC tissues. Gut microbiota was analyzed through16S rRNA sequencing. Results The main components of KD consist of gallic acid, paeoniflorin, emodin, berberine, coptisine, palmatine, jatrorrhizine, baicalein and baicalin. The UC model was successfully established by causing intestinal barrier injury with the loss of intestinal villi and destructed mitochondria of intestinal epithelial cells. Both sulfasalazine and KD treatment repaired UC injury, reduced the levels of malondialdehyde, TNFα, IL-1, IL-6, TLR4, p-PI3K, p-AKT, and p-NF-κB, and increased the levels of SOD, GPx, CAT, and IL-10. KD showed a protective function for the UC model in a dose-dependent way. The serum levels of paeoniflorin and baicalin had a strong relationship with the levels of inflammatory and oxidative stress biomarkers. KD treatment increased the proportion of Alloprevotella, Treponema, Prevotellaceae, and Prevotella, and reduced the proportion of Escherichia_Shigella and Desulfovibrio in gut microbiota. Conclusions KD improved intestinal barrier injury of ulcerative colitis, antioxidant and anti-inflammatory properties by affecting TLR4-dependent PI3K/AKT/NF-κB signaling possibly through the combination of its main compounds, and improving gut microbiota.

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“…There are several limitations of the current study. [25][26][27] First, we enrolled only a small number of patients due to the low incidence of IBD in our center. Our results may not reflect the use of adalimumab for patients with UC in the daily clinical practice in Taiwan.…”

Section: Discussionmentioning

confidence: 99%

“…We opted to shift to another biologic agent for those with a secondary loss of response to adalimumab therapy rather than increasing the dose to try and improve the response rate. 18,19,[25][26][27][28] The levels of the anti-drug antibody after intermittent therapy were also unknown.…”

Section: Discussionmentioning

confidence: 99%

Real‐world experience of adalimumab therapy for patients with ulcerative colitis: A single tertiary medical center experience in Central Taiwan

Yen

Hsu

Kuo

et al. 2022

Adv in Digestive Medicine

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There are few studies on the treatment outcomes of adalimumab therapy in Taiwanese patients with ulcerative colitis (UC). A total of 102 patients with ulcerative colitis were identified from the electronic clinical database of the Changhua Christian Hospital. The demographic data and clinical features of the disease pattern of the UC patients receiving adalimumab therapy were retrospectively reviewed. Between January 2015 and June 2020, 18 patients with UC received adalimumab therapy. Due to the absence of a response, 5 of the 18 patients (27.7%) only received the induction therapy. Of the 13 patients who received maintenance adalimumab therapy, four discontinued the therapy: three (23.1%) stopped due to a loss of response, and one (7.7%) stopped due to a cutaneous reaction to adalimumab. Because of Taiwan's 1-year limit on the use of adalimumab, seven patients relapsed and required a second course of therapy. The median period between course completion and relapse was 31 weeks. Two (20%) of the ten patients who finished the first course of therapy did not experience a relapse. The treatment response of patients with UC to adalimumab therapy appears to be comparable to those in previously published Western studies. The majority of patients who responded to adalimumab will relapse following a limited duration of adalimumab therapy in Taiwan.

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Epidemiological data and utilization patterns of anti-TNF alpha therapy in the Hungarian ulcerative colitis population between 2012-2016

Cited by 8 publications

References 17 publications

Treatment patterns and intensification within 5 year of follow-up of the first-line anti-TNFα used for the treatment of IBD: Results from the VERNE study

Treatment patterns and intensification within 5 year of follow-up of the first-line anti-TNFα used for the treatment of IBD: Results from the VERNE study

Kuijieyuan Decoction Improved Intestinal Barrier Injury of Ulcerative Colitis by Affecting TLR4-Dependent PI3K/AKT/NF-κB Oxidative and Inflammatory Signaling and Gut Microbiota

Real‐world experience of adalimumab therapy for patients with ulcerative colitis: A single tertiary medical center experience in Central Taiwan

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