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Five-year Safety Data From ENCORE, a European Observational Safety Registry for Adults With Crohn's Disease Treated With Infliximab [Remicade®] or Conventional Therapy.
D'Haens, Geert; Reinisch, Walter; Colombel, Jean-Frederic; Panes, Julian; Ghosh, Subrata; Prantera, Cosimo; Lindgren, Stefan; Hommes, Daniel W; Huang, Zhiping; Boice, Judith; Huyck, Susan; Cornillie, Freddy.
Afiliación
  • D'Haens G; Department of Gastroenterology, Academic MedicalCenter, Amsterdam, The Netherlands.
  • Reinisch W; Klinische Abt. Gastroenterologie & Hepatologie, Medical University, Vienna, Austria and McMaster University, Hamilton, ON, Canada.
  • Colombel JF; Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
  • Panes J; Department of Gastroenterology, Hospital Clinic de Barcelona, IDIBAPS, CIBERehd, Barcelona, Spain.
  • Ghosh S; Department of Gastroenterology, University of Calgary, Calgary, AB, Canada.
  • Prantera C; Department of Gastroenterology, A.O. San Camillo Forlanini, Rome, Italy.
  • Lindgren S; Department of Gastroenterology, Lund University, University Hospital Skane, Malmö, Sweden.
  • Hommes DW; Centre for Inflammatory Bowel Diseases, Univerisity of California Los Angeles, Los Angeles, CA, USA.
  • Huang Z; Centre for Biostatistics, Merck Inc., Kenilworth, NJ, USA.
  • Boice J; Centre for Biostatistics, Merck Inc., Kenilworth, NJ, USA.
  • Huyck S; Centre for Biostatistics, Merck Inc., Kenilworth, NJ, USA.
  • Cornillie F; Global Medical Affairs, MSD International GmbH, Lucerne, Switzerland.
J Crohns Colitis ; 11(6): 680-689, 2017 Jun 01.
Article en En | MEDLINE | ID: mdl-28025307
BACKGROUND AND AIMS: The ENCORE registry aimed at comparing the long-term safety of Crohn's disease [CD] treatment with infliximab [Remicade®] and with conventional therapies in real-world clinical practice. METHODS: The 5-year, prospective, observational ENCORE registry followed patients with CD in nine European countries, who received treatment with infliximab, conventional therapies, or switched to infliximab from conventional therapy. Adverse events [AEs] in pre-specified categories and serious AEs were recorded at least every 6 months of the 5-year observation period. Frequency of events was evaluated, and multivariable analyses using follow-up time [Cox proportion hazards model] and exposure time [Poisson regression] were used to identify risk factors for time to AEs in pre-specified categories. RESULTS: Patients who received infliximab [N = 1541], conventional therapies [N = 1121], or switched to infliximab [N = 298] were followed for medians of 60.4, 55.6, and 42.5 months, respectively. Infliximab median exposure was 18.7 and 19.3 months in the infliximab and switched-to-infliximab groups, respectively. In time-to-event Cox proportion hazards [PH] analyses adjusting for confounders, infliximab [vs conventional therapy] was associated with serious infections (hazard ratio [HR] = 1.64, 95% confidence interval [CI]: 1.17, 2.31] and haematological conditions [HR = 2.91, CI: 1.51, 5.59], and not associated with lymphoproliferative disorders/malignancy [HR = 1.44, CI: 0.86, 2.42] or death [HR = 1.22, CI: 0.63, 2.36]. Prednisone use was associated with higher mortality [HR = 3.58, CI: 1.49, 8.61]. In exposure-adjusted Poisson regression analyses, infliximab was associated with lower mortality (risk ratio [[RR] 0.39, CI: 0.17, 0.88]). CONCLUSIONS: Data from 5-year safety follow-up of patients with CD in the ENCORE registry demonstrate that infliximab [Remicade®] exposure is associated with increased risk of serious infections and haematological conditions, whereas mortality may be decreased.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Fármacos Gastrointestinales / Enfermedad de Crohn / Infliximab / Enfermedades Hematológicas / Infecciones Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Aspecto: Patient_preference Límite: Adolescent / Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: J Crohns Colitis Asunto de la revista: GASTROENTEROLOGIA Año: 2017 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Fármacos Gastrointestinales / Enfermedad de Crohn / Infliximab / Enfermedades Hematológicas / Infecciones Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Aspecto: Patient_preference Límite: Adolescent / Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: J Crohns Colitis Asunto de la revista: GASTROENTEROLOGIA Año: 2017 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Reino Unido