Comparative Efficacy for Infliximab Vs Vedolizumab in Biologic Naive Ulcerative Colitis
Autor: | Emily C L Wong, Parambir S. Dulai, Jean-Frederic Colombel, John Marshall, Neeraj Narula, Walter Reinisch |
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Rok vydání: | 2022 |
Předmět: |
medicine.medical_specialty
Antibodies Monoclonal Humanized Gastroenterology Inflammatory bowel disease Vedolizumab Gastrointestinal Agents Adrenal Cortex Hormones Internal medicine Post-hoc analysis medicine Humans Biological Products Hepatology business.industry Odds ratio medicine.disease Ulcerative colitis Infliximab Clinical trial Treatment Outcome Cohort Colitis Ulcerative business medicine.drug |
Zdroj: | Clinical Gastroenterology and Hepatology. 20:1588-1597.e3 |
ISSN: | 1542-3565 |
Popis: | Background & Aims Comparative effectiveness studies are needed to help position therapies for ulcerative colitis (UC). We compared the efficacy of infliximab vs vedolizumab for moderate to severe biologic-naive UC using patient-level data from clinical trial program data sets. Methods This was a post hoc analysis of 3 UC clinical trial programs that included data on 795 biologic-naive UC patients. Differences in proportions of patients achieving week 6 clinical remission (CR) and response, and 1-year CR, corticosteroid-free CR, and endoscopic remission (ER), are reported. Multivariate logistic regression was used to adjust for potential confounders. As a sensitivity analysis, propensity scores were calculated and a cohort of matched participants with similar distribution of baseline covariates was created. All analyses were intention-to-treat. Results At week 6, comparable proportions of patients achieved clinical response and CR with infliximab vs vedolizumab (clinical response, 60.5% [138 of 228] vs 60.0% [340 of 567]; P = .884; and CR, 39.9% [91 of 228] vs 38.6% [219 of 567]; P = .736). Similar proportions of patients achieved 1-year CR with infliximab vs vedolizumab (39.9% [91 of 228] vs 38.6% [219 of 567]; adjusted odds ratio [aOR], 1.02; 95% CI, 0.74–1.40). Infliximab-treated patients had significantly higher rates of 1-year ER (36.0% [82 of 228] vs 25.6% [145 of 567]; aOR, 1.60; 95% CI, 1.12–2.28) and corticosteroid-free CR (29.5% [23 of 78] vs 15.0% [38 of 254]; aOR, 2.36; 95% CI, 1.27–4.39). Similar results were observed in the propensity score matched cohort. Conclusions Although infliximab and vedolizumab have similar efficacy in clinical symptom improvement, infliximab had higher rates of 1-year corticosteroid-free CR and ER in treatment of biologic-naive UC. |
Databáze: | OpenAIRE |
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