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Prevalence of anti-TNF contraindications in Crohn’s disease: A cross-sectional survey from the GETAID

Aurelien Amiot 1, * Philippe Seksik 2 Jean-Marie Reimund 3 Maria Nachury 4 Romain Altwegg 5 Arnaud Bourreille 6 Stephanie Viennot 7 Mathurin Fumery 8, 9 Xavier Roblin 10 Mélanie Serrero 11 Matthieu Allez 12 Claire Painchart 13 Elise Chanteloup 14 Lucine Vuitton 15 Ginette Fotsing 16 Anthony Buisson 17 Baya Coulibaly 18 Stephane Nancey 19 Cyrielle Gilletta 20 Laurianne Plastaras 21 Vered Abitbol 22 Lucas Guillo 23 Marion Simon 24 Stephane Nahon 25 David Laharie 26, 27 Laurent Peyrin-Biroulet 28, 29 Guillaume Bouguen 28, 29 
Abstract : BACKGROUND: The exact rate of contraindications to anti-TNF therapy and physician perspectives on treatment choices facing to anti-TNF contraindication, are poorly reported. METHODS: A two-week cross-sectional study was conducted in 31 centres. Physicians completed a questionnaire for a total of 1,314 consecutive outpatients with Crohn’s disease, assessing each patient’s potential contraindications to anti-TNF therapy, the choice of alternative therapy to anti-TNFs, and their preference in an unrestricted reimbursement setting. RESULTS: Among the 1,293 responses to the first item, 148 (11.5%) reported 32 absolute contraindications (2.5%) and 116 relative contraindications (9.0%) to anti-TNF therapy. When asked about their preference of alternative therapies in those cases with contraindications to anti-TNF, physicians chose ustekinumab and vedolizumab, 75.6% and 23.9%, respectively. In multivariable analysis, the choice of vedolizumab was the preferred choice for patients aged > 60 years with the L2 phenotype and the absence of perianal lesions. In a hypothetical setting of unrestricted reimbursement, anti-TNFs remained physicians’ preferred first-line biological therapy choice for 78.2%. CONCLUSION: Anti-TNF contraindications occurred in up to 11.5% of patients with Crohn’s disease. Physicians’ choices for alternative therapy to anti-TNF relied on ustekinumab in 75.6% and vedolizumab in 23.9% of these cases. This choice was driven mainly by phenotypical criteria and age.
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Submitted on : Thursday, June 30, 2022 - 3:08:36 PM
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Aurelien Amiot, Philippe Seksik, Jean-Marie Reimund, Maria Nachury, Romain Altwegg, et al.. Prevalence of anti-TNF contraindications in Crohn’s disease: A cross-sectional survey from the GETAID. Digestive and Liver Disease, WB Saunders, 2022, ⟨10.1016/j.dld.2022.04.011⟩. ⟨hal-03690498⟩



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