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

J 2024

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

HRADSKY, Ondrej, Ivana COPOVA, Marianna DURILOVA, Denis KAZEKA, Tereza LERCHOVA et. al.

Základní údaje

Originální název

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

Autoři

Vydání

Pediatric Research, London, Nature Publishing Group, 2024, 0031-3998

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30209 Paediatrics

Stát vydavatele

Velká Británie a Severní Irsko

Utajení

není předmětem státního či obchodního tajemství

Odkazy

URL

Impakt faktor

Impact factor: 3.600 v roce 2022

Organizační jednotka

Lékařská fakulta

DOI

http://dx.doi.org/10.1038/s41390-023-02913-7

UT WoS

001114079400002

Klíčová slova anglicky

Crohn’s disease; biologic treatment; paediatric patients

Štítky

14110317

Příznaky

Mezinárodní význam, Recenzováno

Změněno: 4. 3. 2024 10:39, Mgr. Tereza Miškechová

Anotace

V originále

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.ImpactOur 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.

Citovat

HRADSKY, Ondrej, Ivana COPOVA, Marianna DURILOVA, Denis KAZEKA, Tereza LERCHOVA, Katarina MITROVA, Jan SCHWARZ, Romana VETROVCOVA, Nabil EL-LABABIDI, Eva KARASKOVA, Maria VEGHOVA-VELGANOVA, Astrid SULAKOVA, Lucie GONSORCIKOVA, Markéta SOBOTKOVÁ, Ivana ZENISKOVA, Martin ZIMEN, Martin BORTLIK a Jiri BRONSKY. Sustainability of biologic treatment in paediatric patients with Crohn's disease: population-based registry analysis. Pediatric Research. London: Nature Publishing Group, 2024, 9 s. ISSN 0031-3998. Dostupné z: https://dx.doi.org/10.1038/s41390-023-02913-7.

@article{2371845,
   author = {Hradsky, Ondrej and Copova, Ivana and Durilova, Marianna and Kazeka, Denis and Lerchova, Tereza and Mitrova, Katarina and Schwarz, Jan and Vetrovcova, Romana and ElandLababidi, Nabil and Karaskova, Eva and VeghovaandVelganova, Maria and Sulakova, Astrid and Gonsorcikova, Lucie and Sobotková, Markéta and Zeniskova, Ivana and Zimen, Martin and Bortlik, Martin and Bronsky, Jiri},
   article_location = {London},
   doi = {http://dx.doi.org/10.1038/s41390-023-02913-7},
   keywords = {Crohn’s disease; biologic treatment; paediatric patients},
   language = {eng},
   issn = {0031-3998},
   journal = {Pediatric Research},
   title = {Sustainability of biologic treatment in paediatric patients with Crohn's disease: population-based registry analysis},
   url = {https://www.nature.com/articles/s41390-023-02913-7},
   year = {2024}
}

TY  - JOUR
ID  - 2371845
AU  - Hradsky, Ondrej - Copova, Ivana - Durilova, Marianna - Kazeka, Denis - Lerchova, Tereza - Mitrova, Katarina - Schwarz, Jan - Vetrovcova, Romana - El-Lababidi, Nabil - Karaskova, Eva - Veghova-Velganova, Maria - Sulakova, Astrid - Gonsorcikova, Lucie - Sobotková, Markéta - Zeniskova, Ivana - Zimen, Martin - Bortlik, Martin - Bronsky, Jiri
PY  - 2024
TI  - Sustainability of biologic treatment in paediatric patients with Crohn's disease: population-based registry analysis
JF  - Pediatric Research
PB  - Nature Publishing Group
SN  - 00313998
KW  - Crohn’s disease
KW  - biologic treatment
KW  - paediatric patients
UR  - https://www.nature.com/articles/s41390-023-02913-7
N2  - 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.ImpactOur 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.
ER  -

HRADSKY, Ondrej, Ivana COPOVA, Marianna DURILOVA, Denis KAZEKA, Tereza LERCHOVA, Katarina MITROVA, Jan SCHWARZ, Romana VETROVCOVA, Nabil EL-LABABIDI, Eva KARASKOVA, Maria VEGHOVA-VELGANOVA, Astrid SULAKOVA, Lucie GONSORCIKOVA, Markéta SOBOTKOVÁ, Ivana ZENISKOVA, Martin ZIMEN, Martin BORTLIK a Jiri BRONSKY. Sustainability of biologic treatment in paediatric patients with Crohn's disease: population-based registry analysis. \textit{Pediatric Research}. London: Nature Publishing Group, 2024, 9 s. ISSN~0031-3998. Dostupné z: https://dx.doi.org/10.1038/s41390-023-02913-7.

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