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Efficacy and Safety of Combination Targeted Therapies in Immune-Mediated Inflammatory Disease: The COMBIO Study.

Lucas Guillo 1 Benoit Flachaire 2 Jérôme Avouac 3, 4 Catherine Dong 5, 6 Maria Nachury 7 Guillaume Bouguen 8, 9 Anthony Buisson 10 Ludovic Caillo 11 Mathurin Fumery 12, 13 Cyrielle Gilletta 14 Xavier Hébuterne 15 Pierre Lafforgue 16 David Laharie 17, 18 Emmanuel Mahé 19 Hubert Marotte 20 Stéphane Nancey 21 Sébastien Ottaviani 22 Jean-Hugues Salmon 23 Guillaume Savoye 24, 25, 26, 27 Mélanie Serrero 28 Mathieu Uzzan 29 Manuelle Viguier 30 Christophe Richez 31, 32, 33 Laurent Peyrin-Biroulet 8, 9 Philipe Seksik Thao Pham 34 
Abstract : BACKGROUND: Use of a combination of targeted therapies (COMBIO) in patients with refractory/overlapping immune-mediated inflammatory diseases (IMIDs) has increased, but reported data remain scarce. We aimed to assess effectiveness and safety of COMBIO in patients with IMIDs. METHODS: We conducted a French ambispective multicenter cohort study from September 2020 to May 2021, including adults' patients with 1 or 2 IMIDs and treated at least 3-month with COMBIO. RESULTS: Overall, 143 patients were included. The most common IMIDs were Crohn's disease (63.6%), axial spondyloarthritis (37.7%), and ulcerative colitis (14%). Half of patients had only one IMID, of which 60% were Crohn's disease. Mean duration of COMBIO was 274.5±59.3 weeks, and COMBIO persistence at 104 weeks was estimated at 64.1%. The most frequent COMBIOs combined anti-TNF agents with vedolizumab (30%) or ustekinumab (28.7%). Overall, 50% of patients achieved significant and 27% mild-to-moderate improvement in patient-reported outcomes. Extended duration of COMBIO (aOR=1.09; 95% CI: 1.03-1.14; p=0.002) and diagnoses of two IMIDs (aOR=3.46; 95%CI: 1.29-9.26; p=0.013) were associated with significant improvement in patient-reported outcomes. Incidence of serious infection during COMBIO was 4.51 per 100 person-years (95% CI 2.20-8.27) and 5 COMBIOs were discontinued due to adverse events. CONCLUSIONS: COMBIO can be effective and safe in patients with refractory/overlapping IMIDs.
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https://hal-u-picardie.archives-ouvertes.fr/hal-03760906
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Soumis le : jeudi 25 août 2022 - 16:54:49
Dernière modification le : jeudi 1 septembre 2022 - 04:06:35

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Lucas Guillo, Benoit Flachaire, Jérôme Avouac, Catherine Dong, Maria Nachury, et al.. Efficacy and Safety of Combination Targeted Therapies in Immune-Mediated Inflammatory Disease: The COMBIO Study.. Digestive and Liver Disease, Elsevier, 2022, pp.S1590-8658(22)00595-3. ⟨10.1016/j.dld.2022.07.012⟩. ⟨hal-03760906⟩

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