%0 Journal Article
%A Taxonera, Carlos
%A Rodríguez, Cristina
%A Bertoletti, Federico
%A Menchen, Luís
%A Arribas, Julia
%A Sierra, Monica
%A Arias, Lara
%A Martinez-Montiel, Pilar
%A Juan, Alba
%A Iglesias, Eva
%A Algaba, Alicia
%A Manceñido, Noemi
%A Rivero, Montserrat
%A Barreiro-de Acosta, Manuel
%A Lopez-Serrano, Pilar
%A Arguelles-Arias, Federico
%A Gutierrez, Ana
%A Busquets, David
%A Gisbert, Javier P
%A Olivares, David
%A Calvo, Marta
%A Alba, Cristina
%T Clinical Outcomes of Golimumab as First, Second or Third Anti-TNF Agent in Patients with Moderate-to-Severe Ulcerative Colitis.
%D 2017
%U http://hdl.handle.net/10668/11368
%X Golimumab efficacy data in ulcerative colitis (UC) are limited to anti-tumor necrosis factor α (TNF)-naive patients. The aim of this study was to assess the short-term and long-term efficacy of golimumab used as first, second, or third anti-TNF in UC in a real-life clinical setting. This retrospective multicenter cohort study included patients with moderate-to-severe UC treated with golimumab. The primary efficacy endpoints were short-term partial Mayo score response, long-term golimumab failure-free survival, and colectomy-free survival. In 142 patients with UC, golimumab was administered as first (40%), second (23%), or third anti-TNF (37%). Ninety-two patients (65%, 95% confidence interval 56.6-73) achieved short-term clinical response. Forty-five patients (32%, 95% confidence interval 23.7-39.7) achieved clinical remission. Response rates for golimumab were 75% as first anti-TNF, 70% as second anti-TNF (ns versus first anti-TNF), and 50% as third anti-TNF (P = 0.007 versus first anti-TNF). After 12 months median follow-up (interquartile range 6-18), 60 patients (42%, 95% confidence interval 34-51) had golimumab failure, and 15 patients (11%) needed colectomy. Thirty-one patients (22%) needed golimumab dose escalation, and 71% of these regained response after escalation. Starting maintenance with 100 mg golimumab doses and short-term nonresponse were independent predictors of golimumab failure. In this real-life cohort of patients with UC, golimumab therapy was effective for inducing and maintaining clinical response. Although anti-TNF-naive patients had better outcomes, golimumab was also effective in anti-TNF-experienced patients. Only the patients given golimumab after previous failure of 2 anti-TNF agents had significantly worse outcomes. Golimumab dose escalation was beneficial and safe.
%K Ulcerative colitis
%K Golimumab
%K Adalimumab
%K Infliximab
%K Secondary loss of response
%K Dose escalation
%K Colectomy
%K Anti-TNF
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