Tursi Antonio, Mocci Giammarco, Faggiani Roberto, Allegretta Leonardo, Valle Nicola Della, Forti Giacomo, Franceschi Marilisa, Ferronato Antonio, Gallina Sara, Larussa Tiziana, Luzza Francesco, Lorenzetti Roberto, Penna Antonio, Rodino Stefano, Sebkova Ladislava, Lauria Angelo, Piergallini Simona, Pranzo Giuseppe, Ricciardelli Cristina, Zampaletta Costantino, Elisei Walter, Picchio Marcello
Territorial Gastroenterology Service, ASL BAT, Andria (Antonio Tursi).
Division of Gastroenterology, "Brotzu" Hospital, Cagliari (Giammarco Mocci).
Ann Gastroenterol. 2019 Jul-Aug;32(4):392-399. doi: 10.20524/aog.2019.0377. Epub 2019 Apr 22.
The purpose of this study was to assess the efficacy and safety of biosimilar infliximab (IFX) CT-P13 in treating outpatients with inflammatory bowel disease (IBD) in Italian primary gastroenterology centers.
Consecutive IBD outpatients who completed the induction treatment were evaluated retrospectively. Clinical activity was scored according to the Mayo score for ulcerative colitis (UC) and to the Harvey-Bradshaw Index (HBI) for Crohn's disease (CD). The primary endpoint was the achievement of clinical remission (Mayo score ≤2 in UC and HBI ≤5 in CD). Secondary endpoints were clinical response to treatment, achievement of mucosal healing, and safety.
One hundred forty-one patients (96 UC and 45 CD) were enrolled. Previous treatment with anti-tumor necrosis factor (TNF)α had been provided to 26% of UC patients and 28.9% of CD patients. Remission was achieved in 57.3% UC patients and in 75.6% CD patients during a median (interquartile range) follow up of 24 (6-24) months. Clinical response and mucosal healing were achieved in 87.5% and 75.0% of UC patients and in 84.4% and 84.2% of CD patients, respectively. By both univariate and multivariate analysis, age >40 years, presence of comorbidities, and naivety to anti-TNFα were significantly related to remission. Only one (0.7%) adverse event was reported in the CD group. Surgery was performed in 2.1% of UC patients and 6.7% of CD patients. Switching from IFX originator to biosimilar did not influence the maintenance of the clinical remission.
This study confirmed the long-term efficacy and safety of CT-P13 therapy in IBD, in both naïve patients and those switching from IFX originator.
本研究旨在评估生物类似药英夫利昔单抗(IFX)CT-P13在意大利初级胃肠病学中心治疗炎症性肠病(IBD)门诊患者的疗效和安全性。
对完成诱导治疗的连续性IBD门诊患者进行回顾性评估。根据溃疡性结肠炎(UC)的梅奥评分和克罗恩病(CD)的哈维-布拉德肖指数(HBI)对临床活动进行评分。主要终点是实现临床缓解(UC患者梅奥评分≤2,CD患者HBI≤5)。次要终点是治疗的临床反应、黏膜愈合和安全性。
共纳入141例患者(96例UC患者和45例CD患者)。26%的UC患者和28.9%的CD患者曾接受过抗肿瘤坏死因子(TNF)α治疗。在中位(四分位间距)24(6 - 24)个月的随访期间,57.3%的UC患者和75.6%的CD患者实现缓解。UC患者中分别有87.5%和75.0%实现临床反应和黏膜愈合,CD患者中分别有84.4%和84.2%实现临床反应和黏膜愈合。单因素和多因素分析均显示,年龄>40岁、存在合并症以及未使用过抗TNFα与缓解显著相关。CD组仅报告了1例(0.7%)不良事件。2.1%的UC患者和6.7%的CD患者接受了手术。从原研IFX转换为生物类似药并不影响临床缓解的维持。
本研究证实了CT-P13治疗IBD的长期疗效和安全性,无论是初治患者还是从原研IFX转换过来的患者。