95040 20231027130638.0 doi 10.1093/ibd/izz192 sideral 117227 ART-2020-117227 eng Casanova, M.J. Effectiveness and Safety of the Sequential Use of a Second and Third Anti-TNF Agent in Patients with Inflammatory Bowel Disease: Results from the Eneida Registry 2020 Access copy available to the general public Unrestricted Background: The effectiveness of the switch to another anti-tumor necrosis factor (anti-TNF) agent is not known. The aim of this study was to analyze the effectiveness and safety of treatment with a second and third anti-TNF drug after intolerance to or failure of a previous anti-TNF agent in inflammatory bowel disease (IBD) patients. Methods: We included patients diagnosed with IBD from the ENEIDA registry who received another anti-TNF after intolerance to or failure of a prior anti-TNF agent. Results: A total of 1122 patients were included. In the short term, remission was achieved in 55% of the patients with the second anti-TNF. The incidence of loss of response was 19% per patient-year with the second anti-TNF. Combination therapy (hazard ratio [HR], 2.4; 95% confidence interval [CI], 1.8-3; P < 0.0001) and ulcerative colitis vs Crohn''s disease (HR, 1.6; 95% CI, 1.1-2.1; P = 0.005) were associated with a higher probability of loss of response. Fifteen percent of the patients had adverse events, and 10% had to discontinue the second anti-TNF. Of the 71 patients who received a third anti-TNF, 55% achieved remission. The incidence of loss of response was 22% per patient-year with a third anti-TNF. Adverse events occurred in 7 patients (11%), but only 1 stopped the drug. Conclusions: Approximately half of the patients who received a second anti-TNF achieved remission; nevertheless, a significant proportion of them subsequently lost response. Combination therapy and type of IBD were associated with loss of response. Remission was achieved in almost 50% of patients who received a third anti-TNF; nevertheless, a significant proportion of them subsequently lost response. info:eu-repo/semantics/openAccess All rights reserved http://www.europeana.eu/rights/rr-f/ 5.325 2020 GASTROENTEROLOGY & HEPATOLOGY 30 / 92 = 0.326 2020 Q2 T1 1.931 2020 Immunology and Allergy 2020 Q1 Gastroenterology 2020 Q1 info:eu-repo/semantics/article info:eu-repo/semantics/acceptedVersion Chaparro, M. Mínguez, M. Ricart, E. Taxonera, C. García-López, S. Universidad de Zaragoza (orcid)0000-0003-3970-5457 Guardiola, J. López-San Román, A. Iglesias, E. Beltrán, B. Sicilia, B. Vera, M.I. Hinojosa, J. Riestra, S. Domènech, E. Calvet, X. Pérez-Calle, J.L. Martín-Arranz, M.D. Aldeguer, X. Rivero, M. Monfort, D. Barrio, J. Esteve, M. Márquez, L. Lorente, R. García-Planella, E. De Castro, L. Bermejo, F. Merino, O. Rodríguez-Pérez, A. Martínez-Montiel, P. Van Domselaar, M. Alcaín, G. Domínguez-Cajal, M. Muñoz, C. Gomollón, F. Universidad de Zaragoza (orcid)0000-0003-0076-3529 Fernández-Salazar, L. García-Sepulcre, M.F. Rodríguez-Lago, I. Gutiérrez, A. Argüelles-Arias, F. Rodriguez, C. Rodríguez, G.E. Bujanda, L. Llaó, J. Varela, P. Ramos, L. Huguet, J.M. Almela, P. Romero, P. Navarro-Llavat, M. Abad, Á. Ramírez-De La Piscina, P. Lucendo, A.J. Sesé, E. Madrigal, R.E. Charro, M. García-Herola, A. Pajares, R. Khorrami, S. Gisbert, J.P. 1007 610 Universidad de Zaragoza Dpto. Medicina, Psiqu. y Derm. Area Medicina 26, 4 (2020), 606-616 Inflamm. bowel dis. INFLAMMATORY BOWEL DISEASES 1078-0998 276742 http://zaguan.unizar.es/record/95040/files/texto_completo.pdf Postprint 564000 http://zaguan.unizar.es/record/95040/files/texto_completo.jpg?subformat=icon icon Postprint oai:zaguan.unizar.es:95040 articulos driver 2023-10-27-12:53:15 ARTICLE