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The aim of the study was to compare the efficacy of biologics in this setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients with CD who were refractory to a first anti-TNF agent, and treated with ustekinumab (UST), vedolizumab (VDZ), or a second anti-TNF drug as a second-line biological agent at 10 French tertiary centres from 2013 to 2019 were retrospectively included in this study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among the 203 patients included, 90 (44%) received UST, 42 (21%) received VDZ and 71 (35%) received a second anti-TNF agent. The first anti-TNF agent was discontinued due to a primary nonresponse in 42 (21%) patients. At weeks 14\u201324, the rates of steroid-free remission were similar between the UST, VDZ and second anti-TNF groups (29%, 38% and 44%, respectively,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.15). With a mean follow-up of 118\u00a0weeks, drug survival was shorter for patients who received ustekinumab treatment (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001). In the case of trough level less than 5\u00a0\u00b5g\/ml, patients treated with a second anti-TNF agent had a higher postinduction remission rate (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002), and drug survival (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0005). No other relevant factors were associated with treatment efficacy, including trough levels greater than 5\u00a0\u00b5g\/ml.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>VDZ, UST and a second anti-TNF agent exhibit similar efficacy in the short term, as second-biological line treatment in patients with CD who are refractory to a first anti-TNF agent, but shorter drug maintenance is observed for patients treated with UST.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12876-022-02583-5","type":"journal-article","created":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T13:37:15Z","timestamp":1669901835000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Efficacy of ustekinumab, vedolizumab, or a second anti-TNF agent after the failure of a first anti-TNF agent in patients with Crohn\u2019s disease: a multicentre retrospective study"],"prefix":"10.1186","volume":"22","author":[{"given":"Cassandra","family":"Rayer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Nachury","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arnaud","family":"Bourreille","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xavier","family":"Roblin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurent","family":"Peyrin-Biroulet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Viennot","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathurin","family":"Flamant","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Laharie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B\u00e9n\u00e9dicte","family":"Caron","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Dewitte","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurent","family":"Siproudhis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathurin","family":"Fumery","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillaume","family":"Bouguen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,12,1]]},"reference":[{"key":"2583_CR1","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1038\/ajg.2009.579","volume":"105","author":"L Peyrin-Biroulet","year":"2010","unstructured":"Peyrin-Biroulet L, Loftus EV, Colombel J-F, et al. 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Data used in this study was anonymized before its use.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"AB received lecture fees from Abbvie, Ferring, Janssen, MSD, Medtronic, Takeda, Tillotts and consultant fees from Abbvie, Ferring, Janssen, MSD and Tillotts; XR reported a relationship with Abbvie, MSD, Janssen Cilag, and Takeda; LPB received consulting fees from Merck, Abbvie, Janssen, Genentech, Ferring, Norgine, Tillots, Vifor, Shire, Therakos, Pharmacosmos, Pil\u00e8ge, BMS, UCB-Pharma, Hospira, Celltrion, Takeda, Biogaran, Boerhinger-Ingelheim, Lilly, Pfizer, and HAC-Pharma. This author also received lecture fees from Merck, Abbvie, Takeda, Janssen Cilag, Ferring, Norgine, Tillots, Vifor, Therakos, HAC-Pharma, and Mitsubishi SV received consulting fees from Abbvie, MSD, Takeda, Vifor Pharma and Ferring. DL declares counseling, boards, transports or fees from Abbvie, Biogaran, Biogen, Ferring, HAC-pharma, Janssen, MSD, Novartis, Pfizer, Prometheus, Roche, Takeda, Theradiag, Tillots. LS received lecture fees from Abbvie, Ferring and MSD. LS received consultant fees from Takeda MFumery declares counseling, boards, transports or fees from Abbvie, Biogen, Ferring, Janssen, MSD, Pfizer, Takeda, Tillots, Gilead, Celgene, Boehringer, Amgen. GB received lecture fees from Abbvie, Ferring, MSD, Takeda and Pfizer and consultant fees from Takeda, Janssen. LS received lecture fees from Abbvie, Ferring and MSD. LS received consultant fees from Takeda and Ferring. The other authors (CR, MN, BC, MD, MFlamant) declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interest"}}],"article-number":"498"}}