Evidence map›Paper›PMID 38012309›Full record

ArticlePediatric research2024

Sustainability of biologic treatment in paediatric patients with Crohn's disease: population-based registry analysis.

Ondrej Hradsky, Ivana Copova, Marianna Durilova, Denis Kazeka, Tereza Lerchova, Katarina Mitrova, Jan Schwarz, Romana Vetrovcova, Nabil El-Lababidi, Eva Karaskova and 8 more

Abstract read
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Article in Pediatric research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.3field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 4 citations in OpenAlex.

  1. Review
  2. Article
  3. Observational
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors at 6 institutions in 1 country.

Ondrej HradskyDepartment of Paediatrics, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic. ondrej.hradsky@gmail.com.ORCID 0000-0001-6193-0488
Ivana CopovaDepartment of Paediatrics, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic.
Marianna DurilovaDepartment of Paediatrics, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic.
Denis KazekaDepartment of Paediatrics, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic.
Tereza LerchovaDepartment of Paediatrics, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic.
Katarina MitrovaDepartment of Paediatrics, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic.
Jan SchwarzDepartment of Paediatrics, Faculty of Medicine in Pilsen, Faculty Hospital, Charles University in Prague, Pilsen, Czech Republic.
Romana VetrovcovaDepartment of Paediatrics, Faculty of Medicine in Pilsen, Faculty Hospital, Charles University in Prague, Pilsen, Czech Republic.
Nabil El-LababidiDepartment of Paediatrics and Inherited Metabolic Disorders, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic.
Eva KaraskovaDepartment of Paediatrics, Faculty of Medicine and Dentistry, University Hospital Olomouc, Olomouc, Czech Republic.
Maria Veghova-VelganovaDepartment of Paediatrics, Faculty of Medicine and Dentistry, University Hospital Olomouc, Olomouc, Czech Republic.
Astrid SulakovaDepartment of Paediatrics, University Hospital Ostrava and Medical Faculty University of Ostrava, Ostrava, Czech Republic.
Lucie GonsorčíkováDepartment of Paediatrics, First Faculty of Medicine, Thomayer University Hospital and Charles University, Prague, Czech Republic.
Marketa VeverkovaDepartment of Paediatrics, Faculty of Medicine, Masaryk University and University Hospital Brno, Brno, Czech Republic.
Ivana ZeniskovaDepartment of Paediatrics, Hospital Ceske Budejovice, Ceske Budejovice, Czech Republic.
Martin ZimenDepartment of Paediatrics, Hospital Jihlava, Jihlava, Czech Republic.
Martin BortlikDepartment of Gastroenterology, Hospital Ceske Budejovice, Ceske Budejovice, Czech Republic.
Jiri BronskyDepartment of Paediatrics, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic.
Charles University · CZUniversity Hospital Olomouc · CZHospital Jihlava · CZMasaryk University · CZNemocnice České Budějovice · CZUniversity of Ostrava · CZ

Funding

Agency of Charles University in PragueMinistry of Health, Czech RepublicUniversity Hospital Motol, Prague, Czech Republic
6 · The paper itself

Abstract

backgroundWe aimed to evaluate the predictors of sustainability of biologic drugs for paediatric patients with Crohn's disease (CD).

methodsThe Czech National Prospective Registry of Biologic and Targeted Therapy of Inflammatory Bowel Disease (CREdIT) was used to identify the biologic treatment courses in paediatric patients with CD. Mixed-effects Cox models and propensity score analyses were employed to evaluate predictors of treatment sustainability.

resultsAmong the 558 observations of 473 patients, 264 were treated with adalimumab (47%), 240 with infliximab (43%), 41 with ustekinumab (7%), and 13 with vedolizumab (2%). Multivariable analysis revealed higher discontinuation risk with infliximab compared to adalimumab (HR = 0.600, 95%CI 0.389-0.926), both overall and in first-line treatment (HR = 0.302, 95%CI 0.103-0.890). Infliximab versus adalimumab was associated with shorter time to escalation (HR = 0.094, 95%CI 0.043-0.203). Propensity-score analysis demonstrated lower sustainability of infliximab (HR = 0.563, 95%CI 1.159-2.725). The time since diagnosis to treatment initiation (HR = 0.852, 95%CI 0.781-0.926) was the most important predictor. Baseline immunosuppressive therapy prolonged sustainability with infliximab (HR = 2.899, 95%CI 1.311-6.410).

conclusionsGiven the results suggesting shorter sustainability, the need for earlier intensification and thus higher drug exposure, and the greater need for immunosuppression with infliximab than with adalimumab, the choice of these drugs cannot be considered completely equitable. IMPACT: Our study identified predictors of sustainability of biologic treatment in paediatric patients with Crohn's disease, including adalimumab (versus infliximab), early initiation of biologic treatment, and normalised baseline haemoglobin levels. Infliximab treatment was associated with earlier intensification, higher drug exposure, and a greater need for immunosuppression. Parents and patients should be fully informed of the disadvantages of intravenous infliximab versus adalimumab during the decision-making process. This study emphasises the importance of not delaying the initiation of biologic therapy in paediatric patients with Crohn's disease.

Indexed as

AdalimumabCrohn DiseaseInfliximabRegistriesAdolescentAntibodies, Monoclonal, HumanizedBiological ProductsChildFemaleHumansMalePropensity ScoreProportional Hazards ModelsProspective StudiesTreatment OutcomeUstekinumabAdalimumabAntibodies, Monoclonal, HumanizedBiological ProductsInfliximabUstekinumabvedolizumab

Identifiers

PMID38012309
OpenAlexW4389057177

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.