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

  • Schultheiss JPD & al.
  • Aliment Pharmacol Ther
  • 16 Jul 2019

  • International Clinical Digest
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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.