IBD: adverse effects of anti-TNFa lead more women than men to discontinue

Takeaway

• Women treated with tumor necrosis factor‐alpha (TNF‐α) inhibitors for IBD are more likely than men to experience adverse effects that prompt them to discontinue therapy.

Why this matters

• Understanding sex-specific differences in responses to TNF‐α inhibitors may help clinicians take more personalized approaches to IBD treatment, potentially reducing drug discontinuation.

Study design

• Researchers studied the health records of patients treated with TNF‐α inhibitors for IBD with a minimum follow-up of 12 months (N=529; 50.1% women; 631 total treatment episodes).
• They analyzed overall and cause-specific treatment adherence using Kaplan-Meier and Cox proportional hazards regression models.
• Funding: None.

Key results

• 289 patients (45.8%) discontinued treatment.
• Factors associated with discontinuation included:
  • Female sex: aHR, 1.42 (95% CI, 1.16-1.74).
  • Greater age at start of therapy per decade: aHR, 1.15 (95% CI, 1.04-1.27).
  • Dose escalation: aHR, 3.74 (95% CI, 2.78-5.02).
• Female sex was associated with adverse effect-prompted discontinuation (aHR, 4.05; 95% CI, 2.36-6.98), but not with discontinuation for other reasons.

Limitations

• The study was retrospective and single center.
• Discontinuation reasons were subject to misclassification bias.