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More ambitious IBD treatment targets are within reach
More ambitious IBD treatment targets are within reach
Recent years have seen an emergence of potential new treatment options in IBD, allowing for more ambitious targets and treatment goals[1][2]
STRIDE II recommendations[1]
Early intervention is key in defining the right path for long-term remission[3][4][5][6][7]
IBD, which includes CD and UC, is a chronic progressive disease that without adequate and timely treatment could lead to irreversible damage.[3][4]
Early effective treatment during the window of opportunity with disease-modifying agents could prevent disease progression[5]
The first advanced therapy is critical in IBD to determine long-term patient outcomes[3][4][5][6][7][8][9]
Switching to a different biologic may increase treatment persistence vs anti-TNFα cycling[8]
In patients with CD experiencing loss of response with adalimumab or infliximab, switching to a treatment with a different MoA resulted in higher probability of persisting with subsequent treatment than for those who switched to a different anti-TNFα.[8]
MITRORS study: time to treatment re-switch to another biologic§[8]
Older age has been associated with a higher incidence of AEs and serious infections during anti-TNF treatment[9]
In elderly patients (aged ≥60 years) with IBD, initiating anti-TNF therapy resulted in higher discontinuation rates due to AEs than for younger patients.[9]
IBDREAM registry: cumulative incidence of treatment discontinuation due to AEs in patients initiating anti-TNF therapy by age group[9]
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* Clinical response or remission are insufficient to be used as long-term targets.[1]
† The cutoff value of faecal calprotectin is dependent on the desired outcome. Lower thresholds (e.g., <100 mg/g) have been proposed for reflecting deep healing (both endoscopic and transmural healing) or histological healing, whereas higher values (e.g., <250 mg/g) reflect less stringent outcomes (e.g., MES of 0 or 1 in UC).[1]
‡ Time to reach clinical response varies based on therapy and mechanism of action.[1]
§ Patients were classified as either within-class switchers if they switched to adalimumab or infliximab, or outside-class switchers if they switched to vedolizumab or ustekinumab.[8]
AE: Adverse event; CD: Crohn’s disease; CI: Confidence interval; CRP: C-reactive protein; FCAL: Faecal calprotectin; HBI: Harvey-Bradshaw Index;
HR: Hazard ratio; HrQoL: Health-related quality of life; MoA: mode of action; PRO: Patient-reported outcome; SES-CD: Simple endoscopic score in CD;
SHR: Subhazard rate; STRIDE: Selecting Therapeutic Targets in Inflammatory Bowel Disease; TNF: Tumour necrosis factor; UC: Ulcerative colitis;
UCEIS: Ulcerative colitis endoscopic index of severity.
CP-321126 - August 2022
