Jesus K Yamamoto-Furusho1, Othman Al Harbi2, Alessandro Armuzzi3, Webber Chan4, Enrique Ponce de Leon5, Jiaming Qian6, Marina Shapina7, Murat Toruner8, Chia-Hung Tu9, Byong Duk Ye10, Morgane Guennec11, Cecilia Sison12, Dirk Demuth13, Olga Fadeeva13, Qasim M Rana Khan13. 1. Inflammatory Bowel Disease Clinic, Department of Gastroenterology, National Institute of Medical Sciences and Nutrition, Mexico City, Mexico. Electronic address: kazuofurusho@hotmail.com. 2. Department of Medicine, College of Medicine, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia. 3. Presidio Columbus Fondazione Policlinico A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, Rome, Italy. 4. Department of Gastroenterology & Hepatology, Singapore General Hospital, Singapore. 5. Fundación Cardio Infantil, Instituto de Cardiología, Bogota, Colombia. 6. Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China. 7. Inflammatory and Functional Bowel Diseases Research Unit, Federal State Budgetary Institution "State Scientific Center of Coloproctology n.a. A.N. Rizhikh" of the Ministry of Public Health of Russian Federation, Moscow, Russian Federation. 8. Ankara University School of Medicine, Ankara, Turkey. 9. National Taiwan University, Taipei, Taiwan. 10. University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea. 11. IQVIA, Saint-Ouen, France. 12. IQVIA, Makati City, Philippines. 13. Takeda Pharmaceutical International AG, Singapore.
Abstract
BACKGROUND: Incidence of inflammatory bowel disease (IBD) is increasing in newly industrialised countries (NICs); however, data on suboptimal response to anti-tumor necrosis factor (anti-TNF) agents are limited. OBJECTIVES: To assess incidence and indicators of suboptimal response to first anti-TNF therapy in IBD patients in NICs. METHODS: A chart review was conducted in ten countries from Asia-Pacific (APAC), Latin America (LatAm), and Russia and the Middle East (RME) regions among patients diagnosed with ulcerative colitis (UC) or Crohn's disease (CD), initiating anti-TNF therapy in 2010-2015. The cumulative incidence of suboptimal response to anti-TNF therapy was assessed using the following indicators: dose escalation or discontinuation, augmentation with non-biologic therapy, IBD-related hospitalization, or surgery. RESULTS: The study included 1,674 patients (570 UC; 1,104 CD). At 24 months, 32.9% of UC (APAC: 45.1%; LatAm: 38.2%; RME: 23.8%) and 41.2% of CD patients (APAC: 54.1%; LatAm: 42.5%; RME: 29.5%) had experienced suboptimal response. The most frequent first indicator was non-biologic therapy augmentation in LatAm (41.7%), IBD-related hospitalization in RME (UC: 50.7%; CD:37.3%) and in APAC for CD (39.1%), and anti-TNF discontinuation in APAC for UC (38.3%). CONCLUSION: Suboptimal response to anti-TNF agents is common in IBD patients in NICs. Observed regional differences in the incidence and indicators may reflect local practice and anti-TNF restrictions in IBD management. NCT REGISTRATION NUMBER: NCT03090139.
BACKGROUND: Incidence of inflammatory bowel disease (IBD) is increasing in newly industrialised countries (NICs); however, data on suboptimal response to anti-tumor necrosis factor (anti-TNF) agents are limited. OBJECTIVES: To assess incidence and indicators of suboptimal response to first anti-TNF therapy in IBDpatients in NICs. METHODS: A chart review was conducted in ten countries from Asia-Pacific (APAC), Latin America (LatAm), and Russia and the Middle East (RME) regions among patients diagnosed with ulcerative colitis (UC) or Crohn's disease (CD), initiating anti-TNF therapy in 2010-2015. The cumulative incidence of suboptimal response to anti-TNF therapy was assessed using the following indicators: dose escalation or discontinuation, augmentation with non-biologic therapy, IBD-related hospitalization, or surgery. RESULTS: The study included 1,674 patients (570 UC; 1,104 CD). At 24 months, 32.9% of UC (APAC: 45.1%; LatAm: 38.2%; RME: 23.8%) and 41.2% of CD patients (APAC: 54.1%; LatAm: 42.5%; RME: 29.5%) had experienced suboptimal response. The most frequent first indicator was non-biologic therapy augmentation in LatAm (41.7%), IBD-related hospitalization in RME (UC: 50.7%; CD:37.3%) and in APAC for CD (39.1%), and anti-TNF discontinuation in APAC for UC (38.3%). CONCLUSION: Suboptimal response to anti-TNF agents is common in IBDpatients in NICs. Observed regional differences in the incidence and indicators may reflect local practice and anti-TNF restrictions in IBD management. NCT REGISTRATION NUMBER: NCT03090139.
Authors: Danielle Bargo; Theo Tritton; Joseph C Cappelleri; Marco DiBonaventura; Timothy W Smith; Takanori Tsuchiya; Sean Gardiner; Irene Modesto; Tim Holbrook; Daniel Bluff; Taku Kobayashi Journal: Inflamm Intest Dis Date: 2021-11-17