Extraintestinal Manifestations in Vedolizumab and Anti-TNF-Treated Patients With Inflammatory Bowel Disease.
Background: Extra-intestinal manifestations (EIMs) can impact morbidity in patients with inflammatory bowel diseases (IBD; Crohn's disease [CD] and ulcerative colitis [UC]). This study compared incidence rates of EIMs in patients with moderate to severe IBD receiving gut-selective vedolizumab (VDZ)...
| Publicado en: | Inflammatory Bowel Diseases Vol. 24; no. 9; pp. 1876 - 1883 |
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| Autores principales: | , , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Oxford University Press / USA
Sep2018
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=132835716&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 132835716 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10780998 N0V jtl: Inflammatory Bowel Diseases issn: 10780998 maglogo: N pubinfo: dt: Sep2018 vid: 24 iid: 9 pid: 622 pub: Oxford University Press / USA artinfo: ui: 132835716 132835716 132835716 10.1093/ibd/izy065 132835716 ppf: 1876 ppct: 7 formats: tig: atl: Extraintestinal Manifestations in Vedolizumab and Anti-TNF-Treated Patients With Inflammatory Bowel Disease. aug: au: Dubinsky, Marla C. Cross, Raymond K. Sandborn, William J. Long, Millie Xue Song Nianwen Shi Yao Ding Eichner, Samantha Pappalardo, Brandee Ganguli, Arijit Wang, Anthony affil: Icahn School of Medicine, Mount Sinai, New York, New York sug: subj: Inflammatory Bowel Diseases Drug Therapy Antibodies, Monoclonal Therapeutic Use Tumor Necrosis Factor Antagonists and Inhibitors Gastrointestinal Agents Therapeutic Use Inflammatory Bowel Diseases Complications Inflammation Human Comparative Studies Adult Descriptive Statistics Linear Regression Crohn Disease Complications Confidence Intervals Skin Diseases Stomatitis, Aphthous Eye Diseases Arthropathy, Neurogenic Cholangitis, Sclerosing Colitis, Ulcerative Complications Incidence Adult: 19-44 years ab: Background: Extra-intestinal manifestations (EIMs) can impact morbidity in patients with inflammatory bowel diseases (IBD; Crohn's disease [CD] and ulcerative colitis [UC]). This study compared incidence rates of EIMs in patients with moderate to severe IBD receiving gut-selective vedolizumab (VDZ) vs those receiving systemic anti--tumor necrosis factor (anti-TNF) therapies. Methods: Adult IBD patients receiving VDZ or anti-TNFs were identified from the MarketScan claims database from September 28, 2012, through September 30, 2016. Incidence rates of EIMs were compared between the 2 cohorts. Descriptive analyses were performed for all courses of treatment. Generalized linear models estimated the impact of treatment on the likelihood of developing EIMs. Results: Compared with patients receiving anti-TNF therapy, VDZ-treated CD patients were 28% more likely to develop "any EIMs" (adjusted incident rate ratio [IRR], 1.28; 95% confidence interval [CI], 1.02-1.62). Specifically, CD patients treated with VDZ were more likely to develop erythema nodosum (IRR, 4.29; 95% CI, 1.73-10.64), aphthous stomatitis (IRR, 3.73; 95% CI, 1.51-9.23), episcleritis/scleritis (IRR, 2.51; 95% CI, 1.02-6.14), arthropathy (IRR, 1.45; 95% CI, 1.15-1.84), primary sclerosing cholangitis (PSC) (IRR, 7.79; 95% CI, 3.32-18.27), and uveitis/iritis (IRR, 2.89; 95% CI, 1.35-6.18). UC patients receiving VDZ did not have a statistically significant increase in "any EIMs" vs patients receiving anti-TNFs, but were more likely to develop specific EIMs (aphthous stomatitis: IRR, 3.67; 95% CI, 1.30-10.34; pyoderma gangrenosum: IRR, 4.42; 95% CI, 1.00-19.45; and PSC: IRR, 3.44; 95% CI, 1.23-9.68). Conclusions: IBD patients receiving VDZ may be more likely to develop EIMs vs patients receiving anti-TNF therapies. The gut-selective inflammatory control of VDZ may potentially limit its clinical effect on EIM prevention. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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