Predictors of drug survival: A cohort study comparing anti‐tumour necrosis factor agents using the Swedish inflammatory bowel disease quality register

Visuri, Isabella; Eriksson, Carl; Olén, Ola; Cao, Yang; Mårdberg, Emelie; Grip, Olof; Gustavsson, Anders; Hjortswang, Henrik; Karling, Pontus; Montgomery, Scott; Myrelid, Pär; Ludvigsson, Jonas F.; Halfvarson, Jonas

doi:10.1111/apt.16525

Cited by 11 publications

(4 citation statements)

References 50 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the absence of head-to-head comparisons, the retrospective evaluation of real-world data is an accepted approach for comparing drug efficacy. DS has been increasingly used as a surrogate for treatment efficacy when evaluating different therapeutic agents in a real-world setting [ 7 , 8 , 9 ]. It measures continuing medication prescription based on ongoing therapeutic efficacy.…”

Section: Discussionmentioning

confidence: 99%

“…Importantly, it reflects real-world practice that allows for treatment optimization, including dose adjustments. The rate of failure and duration of DS for various drugs are different and provide important comparative efficacy data given the paucity of head-to-head trials of advanced therapies in UC [ 7 , 9 ]. DS data, in some respects, may be even more informative than head-to-head trials by more closely resembling real-world practice.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Vedolizumab Is Associated with Longer Drug Sustainability Compared to Infliximab in Moderate-to-Severe Ulcerative Colitis: Long-Term Real-World Cohort Data

Konikoff,

Yanai,

Libchik

et al. 2023

JCM

View full text Add to dashboard Cite

Background and Aim: Drug sustainability (DS) is a surrogate marker for treatment efficacy. We aimed to compare the DS of two main biologics used to treat moderate-to-severe ulcerative colitis (UC), infliximab (IFX) and vedolizumab (VDZ), in a real-world setting. Methods: We conducted a retrospective cohort study at a tertiary medical center in Israel. We included patients treated between 1 December 2017 and 1 May 2021, who were followed for up to 300 weeks. DS was defined as corticosteroid-, surgical-, and hospitalization-free treatment. Results: 217 patients with UC were included. VDZ had a significantly longer median DS of 265.6 weeks compared to IFX’s 106.5 weeks (p = 0.001) in treatment-naïve patients, even when adjusting for disease severity (HR 0.55 95 CI 0.3–0.98, p = 0.042). In treatment-experienced patients, DS was comparable between IFX and VDZ (p = 0.593). Conclusions: VDZ showed significantly longer DS in treatment-naïve patients with UC compared to IFX, also when adjusted for disease severity. There was no difference in DS between VDZ and IFX in treatment-experienced patients and patients switching from one drug to another. VDZ may be a suitable first-line treatment for biologic-naïve patients with moderate-to-severe UC.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Vedolizumab Is Associated with Longer Drug Sustainability Compared to Infliximab in Moderate-to-Severe Ulcerative Colitis: Long-Term Real-World Cohort Data

Konikoff,

Yanai,

Libchik

et al. 2023

JCM

View full text Add to dashboard Cite

show abstract

“…We have previously shown that less than half of all patients with CD who initiate first-line anti-TNF treatment in Sweden continue the drug after 3 years [ 25 ]. Accordingly, many patients require sequential therapies over their disease course.…”

Section: Discussionmentioning

confidence: 99%

Ustekinumab Versus Anti-tumour Necrosis Factor Alpha Agents as Second-Line Biologics in Crohn's Disease

et al. 2023

Self Cite

View full text Add to dashboard Cite

Background There are little data on positioning biologics in Crohn's disease (CD). Aims We aimed to assess the comparative effectiveness and safety of ustekinumab vs tumour necrosis factor-alpha (anti-TNF) agents after first-line treatment with anti-TNF in CD. Methods We used Swedish nationwide registers to identify patients with CD, exposed to anti-TNF who initiated second-line biologic treatment with ustekinumab or second-line anti-TNF therapy. Nearest neighbour 1:1 propensity score matching (PSM) was used to balance the groups. The primary outcome was 3-year drug survival used as a proxy for effectiveness. Secondary outcomes included drug survival without hospital admission, CD-related surgery, antibiotics, hospitalization due to infection and exposure to corticosteroids. Results Some 312 patients remained after PSM. Drug survival at 3 years was 35% (95% CI 26–44%) in ustekinumab compared to 36% (95% CI 28–44%) in anti-TNF-treated patients (p = 0.72). No statistically significant differences were observed between the groups in 3-year survival without hospital admission (72% vs 70%, p = 0.99), surgery (87% vs 92%, p = 0.17), hospital admission due to infection (92% vs 92%, p = 0.31) or prescription of antibiotics (49% vs 50%, p = 0.56). The proportion of patients continuing second-line biologic therapy did not differ by reason for ending first-line anti-TNF (lack of response vs intolerance) or by type of first-line anti-TNF (adalimumab vs infliximab). Conclusion Based on data from Swedish routine care, no clinically relevant differences in effectiveness or safety of second-line ustekinumab vs anti-TNF treatment were observed in patients with CD with prior exposure to anti-TNF. Supplementary Information The online version contains supplementary material available at 10.1007/s10620-023-07897-2.

show abstract

“…5) Some studies have assessed real-world drug survival (DS) rates, long-term effectiveness, and safety of biologics. 6,7) The DS time is the duration of treatment with a drug, where a high value indicates high overall acceptability, including the effectiveness and safety of the drug. Therefore, DS studies are useful for evaluating long-term treatments for chronic diseases in specialties such as rheumatology, der-matology, and gastroenterology.…”

Section: Introductionmentioning

confidence: 99%

Treatment of Inflammatory Bowel Disease with Biologics in Japan: A Single-Center, Retrospective Pharmacoeconomic Study

Saisyo,

Hashimoto,

Ishida

et al. 2024

Biological & Pharmaceutical Bulletin

View full text Add to dashboard Cite

Biologics are essential for treating inflammatory bowel disease (IBD); however, only a few studies have validated cost-effective treatment options and patient factors for biologic use using real-world data from Japanese patients with IBD. Here, we aimed to provide pharmacoeconomic evidence to support clinical decisions for IBD treatment using biologics. We assessed 183 cases (127 patients) of IBD treated with biologics between November 2004 and September 2021. Data on patient background, treatment other than biologics, treatmentrelated medical costs, and effectiveness index (ratio of the C-reactive protein-negative period to drug survival time) were analyzed using univariate and multivariate logistic regression analyses. Drug survival was determined using Kaplan-Meier survival curve analysis. The outcomes were to validate a novel assessment index and elucidate the following aspects using this index: the effectiveness-cost relationship of long-term biologic use in IBD and cost-effectiveness-associated patient factors. Body mass index ≥25 kg/m 2 and duration of hypoalbuminemia during drug survival correlated significantly with the therapeutic effectiveness of biologics. There were no significant differences in surgical, granulocyte apheresis, or adverse-event costs per drug survival time. Biologic costs were significantly higher in the group showing lower effectiveness than in the group showing higher effectiveness. These findings hold major pharmacoeconomic implications for not only improving therapeutic outcomes through the amelioration of low albumin levels and obesity but also potentially reducing healthcare expenditure related to the use of biotherapeutics. To our knowledge, this is the first pharmacoeconomic study based on real-world data from Japanese patients with IBD receiving longterm biologic therapy.

show abstract

Predictors of drug survival: A cohort study comparing anti‐tumour necrosis factor agents using the Swedish inflammatory bowel disease quality register

Cited by 11 publications

References 50 publications

Vedolizumab Is Associated with Longer Drug Sustainability Compared to Infliximab in Moderate-to-Severe Ulcerative Colitis: Long-Term Real-World Cohort Data

Vedolizumab Is Associated with Longer Drug Sustainability Compared to Infliximab in Moderate-to-Severe Ulcerative Colitis: Long-Term Real-World Cohort Data

Ustekinumab Versus Anti-tumour Necrosis Factor Alpha Agents as Second-Line Biologics in Crohn's Disease

Treatment of Inflammatory Bowel Disease with Biologics in Japan: A Single-Center, Retrospective Pharmacoeconomic Study

Contact Info

Product

Resources

About