The Impact of Vedolizumab and Ustekinumab on Articular Extra-Intestinal Manifestations in Inflammatory Bowel Disease Patients: A Real-Life Multicentre Cohort Study
Por:
De Galan, C, Truyens, M, Peeters, H, Gismero, FM, Elorza, A, Torres, P, Vandermeulen, L, Amezaga, AJ, Ferreiro-Iglesias, R, Holvoet, T, Zabana, Y, Reverter, LP, Gonzales, GB, Geldof, J, Varkas, G, De Vos, M and Lobaton, T
Publicada:
23 nov 2022
Ahead of Print:
1 abr 2022
Resumen:
Background and Aims Extra-intestinal manifestations are frequently reported in inflammatory bowel diseases. However, data comparing the effect of vedolizumab and ustekinumab on articular extra-intestinal manifestations are limited. The aim here was to evaluate differences in new-onset and the evolution of pre-existing joint extra-intestinal manifestations during both treatments. Methods An international multicentre retrospective study was performed on inflammatory bowel disease patients who started vedolizumab or ustekinumab between May 2010 and December 2020. Extra-intestinal manifestations were assessed at baseline and joint extra-intestinal manifestations were evaluated throughout the 2-year follow-up. Arthropathy was defined by joint inflammation [arthritis/sacroiliitis], diagnosed by a rheumatologist, and arthralgia as articular pain without confirmed inflammation. Additionally, skin, ocular and hepatic extra-intestinal manifestations were assessed at baseline. Uni- and multivariate analyses were performed. Results In total, 911 patients [vedolizumab: 584; ustekinumab: 327] were included. Deterioration of pre-existing arthropathy and rate of new-onset arthropathy were not significantly associated with vedolizumab over ustekinumab. Arthropathy was used as reason to stop treatment in six vedolizumab and two ustekinumab patients. The odds of developing new arthralgia within 6 months was higher in patients who took vedolizumab compared to ustekinumab (adjusted odds ratio [aOR]: 2.28 [1.01-5.15], p = 0.047). However, this effect was not sustained during the 2-year follow-up (aOR: 1.35 [0.80-2.29], p = 0.259). Deterioration of pre-existing arthralgia was comparable between ustekinumab and vedolizumab-treated patients. In two vedolizumab-treated patients arthralgia was given as the reason to stop treatment. Conclusions Vedolizumab and ustekinumab can be used safely in patients with articular extra-intestinal manifestations. Only a temporary increased risk for developing arthralgia has been observed under vedolizumab.
Filiaciones:
De Galan, C:
Univ Ghent, Dept Internal Med & Paediat, Ghent, Belgium
Univ Ghent, VIB Ctr Inflammat Res IRC, Ghent, Belgium
Univ Ghent, Ghent Gut Inflammat Grp GGIG, Ghent, Belgium
Truyens, M:
Univ Ghent, Dept Internal Med & Paediat, Ghent, Belgium
Univ Ghent, VIB Ctr Inflammat Res IRC, Ghent, Belgium
Univ Ghent, Ghent Gut Inflammat Grp GGIG, Ghent, Belgium
Univ Hosp Ghent, Dept Gastroenterol, Ghent, Belgium
Peeters, H:
AZ Sint Lucas, Dept Gastroenterol, Ghent, Belgium
Gismero, FM:
Hosp Ramon & Cajal, Dept Gastroenterol, Madrid, Spain
Elorza, A:
Hosp Galdakao, Dept Gastroenterol, Bilbao, Spain
:
Hosp Badalona Germans Trias & Pujol, Dept Gastroenterol, Barcelona, Spain
Vandermeulen, L:
Vrije Univ Brussel VUB, Universitair Ziekenhuis Brussel, Dept Gastroenterol, Brussels, Belgium
Amezaga, AJ:
Univ Hosp Antwerp, Dept Gastroenterol, Antwerp, Belgium
Ferreiro-Iglesias, R:
Hosp Clin Univ Santiago, Inst Invest Sanitaria Santiago de Compostela IDIS, Dept Gastroenterol, Santiago De Compostela, Spain
Holvoet, T:
Univ Hosp Ghent, Dept Gastroenterol, Ghent, Belgium
AZ Nikolaas, Dept Gastroenterol, St Niklaas, Belgium
Zabana, Y:
Hosp Univ Mutua Terrassa, Dept Gastroenterol, Barcelona, Spain
Ctr Invest Biomed Red Enfermedades Hepat & Digest, CIBERehd, Barcelona, Spain
Reverter, LP:
Hosp Univ Girona Doctor Joseph Trueta, Dept Gastroenterol, Girona, Spain
Gonzales, GB:
Univ Ghent, Dept Internal Med & Paediat, Ghent, Belgium
Univ Ghent, VIB Ctr Inflammat Res IRC, Ghent, Belgium
Wageningen Univ & Res, Div Human Nutr & Hlth, Nutr Metab & Genom Grp, Wageningen, Netherlands
Geldof, J:
Univ Ghent, Dept Internal Med & Paediat, Ghent, Belgium
Univ Hosp Ghent, Dept Gastroenterol, Ghent, Belgium
Varkas, G:
Univ Ghent, VIB Ctr Inflammat Res IRC, Ghent, Belgium
Univ Hosp Ghent, Dept Rheumatol, Ghent, Belgium
De Vos, M:
Univ Ghent, Dept Internal Med & Paediat, Ghent, Belgium
Univ Ghent, Ghent Gut Inflammat Grp GGIG, Ghent, Belgium
Lobaton, T:
Univ Ghent, Dept Internal Med & Paediat, Ghent, Belgium
Univ Hosp Ghent, Dept Gastroenterol, Ghent, Belgium
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