Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Blesl, A; Binder, L; Högenauer, C; Wenzl, H; Borenich, A; Pregartner, G; Berghold, A; Mestel, S; Kump, P; Baumann-Durchschein, F; Petritsch, W.
Limited long-term treatment persistence of first anti-TNF therapy in 538 patients with inflammatory bowel diseases: a 20-year real-world study.
Aliment Pharmacol Ther. 2021; 54(5):667-677
Doi: 10.1111/apt.16478
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- Führende Autor*innen der Med Uni Graz
- Blesl Andreas
- Co-Autor*innen der Med Uni Graz
- Baumann-Durchschein Franziska
- Berghold Andrea
- Binder Lukas
- Borenich Andrea
- Constantini-Kump Patrizia
- Hoegenauer Christoph
- Mestel Sigrid
- Petritsch Wolfgang
- Pregartner Gudrun
- Wenzl Heimo
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- Abstract:
- BACKGROUND: Anti-TNF antibodies were the first biologic treatment option for patients with inflammatory bowel diseases. AIMS: To assess length of treatment persistence of first anti-TNF therapy and influencing factors used in the standard care of patients with inflammatory bowel diseases. METHODS: Single-centre, retrospective study from a register including patients who received anti-TNF therapy in the last 20 years at the study centre. Kaplan-Meier analysis with log-rank test was used to describe treatment persistence. With multivariable Cox regression analysis, risk factors for treatment failure were investigated. RESULTS: Five hundred thirty-eight patients (CD, Crohn's disease: 367, UC, ulcerative colitis: 147, inflammatory bowel disease unclassified: 24) with a median follow-up of 8.1 years were included. Median (95% confidence interval) treatment persistence in the total cohort was 2.3 years (28 [22, 38] months), and nearly half of patients withdrew from treatment within 2 years. Male patients were treated longer than females (male: 37 [25, 48] months, female: 23 [14, 33] months, P = 0.002). Treatment persistence was longer in CD compared to UC (CD: 39 [30, 50] months, UC: 13 [9, 19] months, P < 0.001), and patients with CD remained longer on adalimumab than on infliximab treatment (adalimumab: 67 [55, 95] months, infliximab: 19 [14, 31] months, P < 0.001). Treatment failure (52%) and side effects (25%) were the most common reasons for withdrawal from therapy; 14% withdrew due to remission. Female sex was identified as independent predictor for treatment failure in UC (hazard ratio [CI]: 1.73 [1.02-2.92], P = 0.04). CONCLUSION: Long-term treatment persistence of first anti-TNF therapy was limited in patients with inflammatory bowel diseases, primarily due to treatment failure and side effects.
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