Indicators of suboptimal tumor necrosis factor antagonist therapy in inflammatory bowel disease

Abstract

The majority of IBD patients showed suboptimal therapy with current anti-TNFs.

Real-World Incidence of Suboptimal Response to Anti-Tumor Necrosis Factor Therapy for Ulcerative Colitis: A Nationwide Population-Based Study

“…21 Despite some numerical differences in the incidences of suboptimal therapy with anti-TNF agents, the present study and previous studies are generally consistent in that more than half of UC patients experience suboptimal responses after initiating biologic therapies, highlighting the unmet need in the treatment of patients with moderate to severe UC. 17,18,21 The frequencies of indicators of suboptimal anti-TNF therapy were similar between previous Western studies and our study, except that fewer patients in our study experienced anti-TNF dose escalation. 17,18 The limited reimbursement for infliximab and golimumab dose escalation in contrast with adalimumab for UC in Korea might have been responsible for the low rates of dose escalation.…”

“…The risk of suboptimal response to anti-TNFs in our study appears to be largely similar to findings from the Western world. 17,18 A previous study using a U.S. com-mercial claims database from 2005 and 2013 showed that 72% and 91% of patients with UC experienced at least one suboptimal response after 12 and 36 months, respectively; these figures were numerically slightly higher than those observed in our study. 17 In contrast, a multinational study using UC patient data from Canada, France, Germany, Italy, Spain, and the United Kingdom reported that 64.1% of anti-TNF initiators experienced at least one suboptimal response within 2 years, which was lower than the frequencies from the U.S. study and those from our study.…”

“…17 In contrast, a multinational study using UC patient data from Canada, France, Germany, Italy, Spain, and the United Kingdom reported that 64.1% of anti-TNF initiators experienced at least one suboptimal response within 2 years, which was lower than the frequencies from the U.S. study and those from our study. 17,18 However, disease-related urgent care was included as a suboptimal response indicator, and augmentation included a wider range of drugs, such as antibiotics, likely contributing to the higher rates of suboptimal responses in the U.S. study compared with ours. 17 Different study populations as well as differences in the study periods; and definitions of discontinuation, augmentation, and practice pattern might also have contributed to the differing results.…”

“…Suboptimal response indicators could be utilized to estimate the effective and safe use of biologics in the realworld. [16][17][18][19][20] However, only limited data are available on suboptimal responses to anti-TNF therapy among UC patients in Asia, especially in the era of biologics other than nonanti-TNFs. 21,22 We aimed to identify suboptimal responses to anti-TNF therapies and differences between anti-TNF agents for UC patients in Korea using nationwide population-based data.…”

Living with ulcerative colitis in Germany: a retrospective analysis of dose escalation, concomitant treatment use and healthcare costs

“…The concomitant use of steroids and immunosuppressants that we observed is high compared with reports in the literature. Medical records for patients with UC in Europe and Canada indicated initiation, or a dose increase, of a non-biologic treatment in combination with adalimumab or infliximab for 21% of patients within 2 years of starting biologic treatment 40 , and analysis of US claims data reported concomitant use of a non-biologic treatment within 1 year of initiation of a biologic in 23% of patients 39 .…”