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Future Pharmacology
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Article

Persistence of Second and Third-Line Biologics in Inflammatory Bowel Disease: A Multi-Centre Cohort Study

by
Timothy P. Hanrahan
1,
Robbie Chan
1,
Daniel Tassone
2,
Nik S. Ding
2,3,
Chamara Basnayake
2,3,
Julien Schulberg
2,
Abhinav Vasudevan
1,
Michael Kamm
2,3,
Michael De Gregorio
2,3,
Daniel R. van Langenberg
1,4 and
Ola Niewiadomski
1,4,*
1
Department of Gastroenterology, Eastern Health, Melbourne, VIC 3128, Australia
2
Department of Gastroenterology, St. Vincent’s Hospital, Melbourne, VIC 3065, Australia
3
Melbourne Medical School, University of Melbourne, Melbourne, VIC 3010, Australia
4
Monash School of Medicine, Monash University, Melbourne, VIC 3800, Australia
*
Author to whom correspondence should be addressed.
Future Pharmacol. 2022, 2(4), 669-680; https://doi.org/10.3390/futurepharmacol2040041
Submission received: 13 October 2022 / Revised: 6 December 2022 / Accepted: 9 December 2022 / Published: 16 December 2022
(This article belongs to the Special Issue Feature Papers in Future Pharmacology)
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Abstract

Background: Despite proven efficacy of biologics in inflammatory bowel disease (IBD), many exhibit primary non-response or secondary loss of response and switch to subsequent biologic(s). Here, we identified early predictors of second- and/or third-line biologic persistence in IBD, in a real-world cohort of patients. Methods: A retrospective multicentre cohort study was conducted on patients receiving second- and/or third-line biologics for IBD from 2005–2021. Cox regression was applied to identify factors predictive of longer cumulative biologic persistence prior to treatment failure. Results: Of 179 patients who received ≥2 biologics, 159 (88.8%) received an anti-tumour necrosis factor (anti-TNF) first-line. There was a significantly increased likelihood of longer treatment persistence in recipients who received an anti-TNF first, versus those that received a non-anti-TNF agent first (p < 0.01). A diagnosis of CD (OR 7.1, 95% CI [2.3–21.7], p < 0.01), and endoscopic remission achieved on the first biologic (OR 10.4 [1.3–79.9], p = 0.03) were positive predictors of longer biologic persistence, whilst advancing age at IBD diagnosis (OR 0.97 [0.94–0.99], p = 0.04) and primary non-response to initial biologic (OR 0.3 [0.1–0.7], p < 0.01) were inversely associated with biologic persistence. Conclusions: These real-world data demonstrate multiple, simple to identify factors that offer the potential for early objectively assessed response to first-line biologic to predict future biologic persistence.
Keywords: Crohn’s disease; ulcerative colitis; infliximab; biologics; persistence Crohn’s disease; ulcerative colitis; infliximab; biologics; persistence

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MDPI and ACS Style

Hanrahan, T.P.; Chan, R.; Tassone, D.; Ding, N.S.; Basnayake, C.; Schulberg, J.; Vasudevan, A.; Kamm, M.; De Gregorio, M.; van Langenberg, D.R.; et al. Persistence of Second and Third-Line Biologics in Inflammatory Bowel Disease: A Multi-Centre Cohort Study. Future Pharmacol. 2022, 2, 669-680. https://doi.org/10.3390/futurepharmacol2040041

AMA Style

Hanrahan TP, Chan R, Tassone D, Ding NS, Basnayake C, Schulberg J, Vasudevan A, Kamm M, De Gregorio M, van Langenberg DR, et al. Persistence of Second and Third-Line Biologics in Inflammatory Bowel Disease: A Multi-Centre Cohort Study. Future Pharmacology. 2022; 2(4):669-680. https://doi.org/10.3390/futurepharmacol2040041

Chicago/Turabian Style

Hanrahan, Timothy P., Robbie Chan, Daniel Tassone, Nik S. Ding, Chamara Basnayake, Julien Schulberg, Abhinav Vasudevan, Michael Kamm, Michael De Gregorio, Daniel R. van Langenberg, and et al. 2022. "Persistence of Second and Third-Line Biologics in Inflammatory Bowel Disease: A Multi-Centre Cohort Study" Future Pharmacology 2, no. 4: 669-680. https://doi.org/10.3390/futurepharmacol2040041

APA Style

Hanrahan, T. P., Chan, R., Tassone, D., Ding, N. S., Basnayake, C., Schulberg, J., Vasudevan, A., Kamm, M., De Gregorio, M., van Langenberg, D. R., & Niewiadomski, O. (2022). Persistence of Second and Third-Line Biologics in Inflammatory Bowel Disease: A Multi-Centre Cohort Study. Future Pharmacology, 2(4), 669-680. https://doi.org/10.3390/futurepharmacol2040041

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