Comorbidities, not age, linked with worse safety outcomes for Entyvio, Stelara
Patients who received Entyvio or Stelara for inflammatory bowel disease who had more comorbidities were at increased risk for hospitalization and infection, according to research published in Alimentary Pharmacology & Therapeutics.
Vera E.R. Asscher, from the department of gastroenterology and hepatology at Leiden University Medical Centre in the Netherlands, and colleagues wrote that recent research has explored patient age as potential risk factor for adverse treatment outcomes in IBD, but the impact of comorbidities has not been as well-explored.
“A patient’s chronological age is an imperfect marker of the reduced physiologic reserve capacity that predisposes patients to an increased risk of adverse treatment outcomes,” they wrote. “The presence of comorbidities could function as a more solid predictor of therapy outcomes as compared to age itself as its presence increases the risk of medication interactions, reduced adherence to treatment and poorer response to treatment.”
To evaluate the association between age and comorbidities with outcomes, researchers enrolled patients with IBD who received Entyvio (vedolizumab, Takeda; n = 203) or Stelara (ustekinumab, Janssen; n = 207) in a prospective study. They used the Charlson Comorbidity Index (CCI) to explore the link between comorbidity prevalence and any infection, hospitalization and adverse events.
Among patients who received vedolizumab, CCI was independently associated with any infection (OR = 1.387; 95% CI, 1.022-1.883) and hospitalization (OR = 1.586; 95% CI, 1.127-2.231).
Among patients who received ustekinumab, CCI was associated with hospitalization (OR = 1.621; 95% CI, 1.034-2.541).
However, investigators found no association between age and any outcomes of therapy.
“Effectiveness of both treatments was not impaired by presence of comorbidities or a higher age,” Asscher and colleagues wrote. “These results underline the importance of assessing comorbidity status instead of age prior to initiating vedolizumab and ustekinumab therapy, in order to discuss additional safety risks and need for close monitoring in IBD patients with multiple comorbidities.”