ArticleClinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association2023
Second-Line Biologic Therapy Following Tumor Necrosis Factor Antagonist Failure: A Real-World Propensity Score-Weighted Analysis.
Article in Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 12 citations in OpenAlex.
- Ustekinumab in Ulcerative Colitis: A Real-Life Effectiveness Study Across Multiple Belgian Centers (SULTAN).Journal of clinical medicine · 2025Article
- Factors driving persistence to first-line advanced therapies in inflammatory bowel disease: a real-world study from a tertiary referral centre.Internal and emergency medicine · 2025Article
- Ustekinumab versus vedolizumab in patients with Crohn's disease refractory to anti-tumour necrosis factor: A systematic review and meta-analysis.Pakistan journal of medical sciences · 2025Review
- Distinct perturbances in metabolic pathways associate with disease progression in inflammatory bowel disease.Journal of Crohn's & colitis · 2025Observational
- Electronic Health Records-based identification of newly diagnosed Crohn's Disease cases.Artificial intelligence in medicine · 2025Article
- Interferon-gamma signaling drives epithelial TNF-alpha receptor-2 expression during colonic tissue repair.FASEB journal : official publication of the Federation of American Societies for Experimental Biology · 2024Article
- Treatment trajectories and outcomes in inflammatory bowel disease: a tertiary single-centre experience.Therapeutic advances in gastroenterology · 2024Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 2 countries.
Funding
Abstract
BACKGROUND&
aimsTumor necrosis factor (TNF) antagonists often are used as first-line medications to treat moderate to severe inflammatory bowel disease (IBD), but many patients do not achieve or maintain response. Our aim was to compare the effectiveness of second-line treatments (ustekinumab, vedolizumab, or a second TNF antagonist) after TNF antagonist exposure in patients with Crohn's disease (CD) and ulcerative colitis (UC) from 2 electronic health records-based cohorts.
methodsWe identified patients with prior TNF antagonist exposure who switched to a different biologic in the Mount Sinai Health System (MSHS) electronic health records (CD, n = 527; UC, n = 165) and the Study of a Prospective Adult Research Cohort (SPARC) from the Inflammatory Bowel Disease Plexus Program of the Crohn's & Colitis Foundation (CD, n = 412; UC, n = 129). Treatment failure was defined as the composite of any IBD-related surgery, IBD-related hospitalization, new prescription of oral/intravenous corticosteroids, or need to switch to a third biologic agent. Time-to-event analysis was conducted with inverse probability of treatment-weighted data.
resultsOverall, treatment failure occurred in 85% of MSHS and 72% of SPARC CD patients. In SPARC, the likelihood of treatment failure was significantly lower with ustekinumab compared with vedolizumab as second-line treatment (adjusted hazard ratio, 0.66; 95% CI, 0.54-0.82; P < .001), a trend confirmed in MSHS (adjusted hazard ratio, 0.89; 95% CI, 0.77-1.04; P = .15). In both cohorts, the superiority of ustekinumab compared with vedolizumab was shown when considering treatment failure as prescription of steroids or a third biologic agent. In UC, no differences between second-line treatment groups were identified.
conclusionsIn 2 independent real-world cohort settings, second-line therapy in CD with ustekinumab after TNF antagonist treatment failure was associated with a lower likelihood of treatment failure than second-line vedolizumab.
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