Impact of Prior Biologic Mechanism of Action on Anti‐ TNF Effectiveness in Inflammatory Bowel Disease: An ENEIDA Registry Study
Year: 2026
Type: article
Study design: Observational Study
Abstract: BACKGROUND: The expanding use of targeted therapies in inflammatory bowel disease has made treatment sequencing increasingly relevant, yet evidence on anti-TNF effectiveness after prior biologics with different mechanisms of action (MOA) remains limited. Our objective is to evaluate the durability of anti-TNF treatment in this scenario. METHODS: Multicentre study based on data from the ENEIDA registry. Patients who received second-line anti-TNF therapy after a first biologic with a different MOA for active luminal disease were identified. Using propensity score matching, each case was matched with three controls from two cohorts: patients treated with second-line anti-TNF after another anti-TNF and patients receiving first-line anti-TNF therapy. Treatment durability and short- and long-term clinical effectiveness were assessed. RESULTS: Sixty-six Crohn's disease patients and 117 UC patients receiving anti-TNF after other MOA were included. In CD, second-line anti-TNF therapy after a different MOA (62% ustekinumab) was associated with a higher risk of treatment discontinuation compared with first-line anti-TNF therapy (HR 1.55; 95% CI, 1.05-2.30), without significant differences in short- or long-term clinical effectiveness. In UC, anti-TNF therapy after a different MOA (90% vedolizumab) was associated with lower treatment durability compared with first-line anti-TNF therapy (HR 1.69; 95% CI, 1.31-2.19) and with anti-TNF after another anti-TNF agent (HR 1.91; 95% CI, 1.48-2.48), its remission rates significantly lower at both short- and long-term follow-up (p < 0.001). CONCLUSIONS: Anti-TNF therapy used after a different MOA is associated with reduced effectiveness and durability compared with its use as first-line therapy or after another anti-TNF agent, especially in UC.
DOI: 10.1111/apt.70904
Authors: Carmen Yagüe Caballero, Santiago García López, Ana Royo Esteban, Laura Figueras Panillo, Pilar Nos, Luisa de Castro, M. Dolores Martín‐Arranz, Manuel Barreiro‐de Acosta, Elena Ricart, Ruth de Francisco, Eva Iglesias, Antonio Giordano, Pilar Varela, Iago Rodríguez‐Lago, Montserrat Rivero, Beatriz Sicilia, Merce Navarro‐Llavat, Isabel Vera, Carles Suria, Jordi Guardiola, Jesús Barrio, Margalida Calafat, Ana Gutiérrez, Xavier Calvet, David Rafael de la Cruz, Francisco Mesonero, Cristina Martínez Pascual, Javier P. Gisbert, Carla J. Gargallo‐Puyuelo, David Monfort i Miquel, Mónica Sierra, Laura Arranz, Cristina Rodríguez‐Gutiérrez, Rufo Lorente, Fernando Bermejo, Lucía Márquez‐Mosquera, Gisela Torres Vicente, José Lázaro Pérez‐Calle, José M. Huguet, Laura Ramos, Ángel Ponferrada‐Díaz, Daniel Ceballos, Mª. Teresa Diz‐Lois Palomares, Eva Sesé Abizanda, Pablo Vega, Ramón Pajares, Javier Santos Fernández, Elena Betoré, David Busquets, Olga Merino, Carlos Martínez‐Flores, Yamile Zabana, Manuela Josefa Sampedro González, Jone Ortiz de Zarate, Ana Fuentes Coronel, Empar Sainz Arnau, Daniel Carpio, Nuria Jiménez, Ignacio Marín‐Jiménez, Luis Bujanda, Raquel Camargo Camero, Martín Irabien, María Abanades Tercero, Benito Velayos Jiménez, Pilar Robledo Andres, Ana María Trapero, Pedro G. Delgado‐Guillena, Luís Hernández Villalba, Margarita Menacho, Nuria Rull Murillo, Carles Leal, Cristina Alba, Rosa Gómez Espín, Alfredo J. Lucendo, Manuel Van Domselaar, Laura García Alles, Eduardo Iyo Miyashiro, Ana Crespo Catalá, Pau Gilabert, Daniel Martín Rodríguez, Víctor Manuel Navas‐López, María Calvo Iñiguez, Daniel Ginard, Teresa Martínez Pérez, Eugeni Domènech, Diego Casas Deza
Institutions: Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria Aragón, Hospital Universitari i Politècnic La Fe, Instituto de Investigación Sanitaria La Fe, Hospital Universitario La Paz, Instituto de Investigación Sanitaria de Santiago, Centro de Investigación Biomédica en Red, Hospital Clínic de Barcelona, Consorci Institut D'Investigacions Biomediques August Pi I Sunyer, Hospital Universitario Central de Asturias, Instituto de Investigación Sanitaria del Principado de Asturias, Instituto Maimónides de Investigación Biomédica de Córdoba, Hospital Universitario Reina Sofía, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, University of Córdoba, Hospital de Sant Pau, Institut de Recerca Sant Pau, Hospital Universitario De Cabueñes, Hospital de Galdakao, Marqués de Valdecilla University Hospital, Instituto de Investigación Marqués de Valdecilla, Hospital Universitario de Burgos, Hospital de Sant Joan Despí Moisès Broggi, Hospital Universitario Puerta de Hierro Majadahonda, Hospital Clínico Universitario de Valencia, Bellvitge University Hospital, Hospital Universitario Río Hortega, Hospital Universitari Germans Trias i Pujol, Hospital General Universitario de Alicante Doctor Balmis, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Universitat Autònoma de Barcelona, Institute of Research and Innovation Parc Tauli, Hospital Universitario 12 De Octubre, Hospital Universitario Ramón y Cajal, Hospital Universitario Virgen de la Arrixaca, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria del Hospital Universitario de La Princesa, Universidad Autónoma de Madrid, Hospital Clínico Universitario Lozano Blesa, Consorci Sanitari de Terrassa, Complejo Asistencial Universitario de León, Hospital Universitario Nuestra Señora de Candelaria, Complejo Hospitalario de Navarra, Hospital General Universitario de Ciudad Real, Hospital Universitario de Fuenlabrada, Hospital Del Mar, Municipal Institute for Medical Research, Hospital del Mar Research Institute, Hospital General de Granollers, Hospital Universitario Fundación Alcorcón, Hospital General Universitario De Valencia, Hospital Universitario de Canarias, Hospital Universitario Infanta Leonor, Universidad de Las Palmas de Gran Canaria, Hospital Universitario de Gran Canaria Doctor Negrín, Complexo Hospitalario Universitario A Coruña, Hospital Universitari Arnau de Vilanova, Complejo Hospitalario de Ourense, Hospital Universitario Infanta Sofía, Universidad Europea de Madrid, Complejo Asistencial Universitario de Palencia, Hospital General San Jorge, Hospital Universitari de Girona Doctor Josep Trueta, Hospital de Cruces, Servicio de Salud de Castilla La Mancha, University Hospital Mútua de Terrassa, Mútua Terrassa, Universitat de Barcelona, Hospital de Mataró, Hospital de Basurto, Althaia, Complejo Hospitalario de Pontevedra, Hospital General Universitario de Elche, Universidad Complutense de Madrid, Hospital General Universitario Gregorio Marañón, University of the Basque Country, Biogipuzkoa Health Research Institute, Hospital Clínico Universitario Virgen de la Victoria, Complejo Hospitalario Universitario de Toledo, Hospital Universitario de Toledo, Hospital Clínico Universitario de Valladolid, Complejo Hospitalario de Cáceres, Complejo Hospitalario de Jaén, Hospital Universitari Joan XXIII de Tarragona, Hospital Son Llatzer, Fundación Hospital Manacor, Universitat de Vic - Universitat Central de Catalunya, Hospital Universitari de Vic, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Hospital Reina Sofía de Murcia, Hospital General de Tomelloso, Universidad Francisco de Vitoria, Hospital Universitario de Torrejón, Hospital Sierrallana, Hospital Comarcal de Inca, Hospital de Viladecans, Hospital Universitario Infanta Cristina, Hospital Regional Universitario de Málaga, Hospital San Pedro, Hospital Universitario Son Espases, Hospital Virgen de la Luz
Language: English
Topic: Inflammatory Bowel Disease
Subfield: Gastroenterology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $5,250
Awards: G1733724753, G2241952478
OpenAlex ID: W7202273560