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.

Basic information

Original name

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

Authors

Edition

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

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30209 Paediatrics

Country of publisher

United Kingdom of Great Britain and Northern Ireland

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

URL

Impact factor

Impact factor: 3.600 in 2022

Organization unit

Faculty of Medicine

DOI

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

UT WoS

001114079400002

Keywords in English

Crohn’s disease; biologic treatment; paediatric patients

Abstract

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 and 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 pp. ISSN 0031-3998. Available from: 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 and 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 pp. ISSN~0031-3998. Available from: https://dx.doi.org/10.1038/s41390-023-02913-7.

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