Prevalence of anti-TNF contraindications in Crohn’s disease: A cross-sectional survey from the GETAID - Archive ouverte HAL Access content directly
Journal Articles Digestive and Liver Disease Year : 2022

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

1 EC2M3 - Early detection of Colon Cancer using Molecular Markers and Microbiota (EA 7375)
2 CRSA - Centre de Recherche Saint-Antoine
3 Voies de Signalisation du Développement et du Stress Cellulaire dans les Cancers Digestifs et Urologiques
4 INFINITE (Ex-Liric) - Institute for Translational Research in Inflammation - U 1286
5 University Hospital of Montpellier
6 CHU Nantes - Centre hospitalier universitaire de Nantes
7 CHU Caen
8 PERITOX - Périnatalité et Risques Toxiques - UMR INERIS_I 1
9 CHU Amiens-Picardie
10 GETAID - Groupe d’Étude Thérapeutique des Affections Inflammatoires du Tube Digestif
11 CHU ST-E - Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne]
12 AMU - Aix Marseille Université
13 AP-HP - Hopital Saint-Louis [AP-HP]
14 Centre hospitalier [Valenciennes, Nord]
15 Hôpital Saint-Joseph [Marseille]
16 CHRU Besançon - Centre Hospitalier Régional Universitaire de Besançon
17 CHU Poitiers - Centre hospitalier universitaire de Poitiers
18 CHU Clermont-Ferrand
19 Centre Hospitalier Henri Duffaut (Avignon)
20 HCL - Hospices Civils de Lyon
21 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
22 CH Colmar
23 Hôpital Cochin [AP-HP]
24 IMM - Institut Mutualiste de Montsouris
25 Groupe Hospitalier Intercommunal Le Raincy-Montfermeil
26 CHU Bordeaux [Bordeaux]
27 NGERE - Nutrition-Génétique et Exposition aux Risques Environnementaux
28 Service d'Hépato-gastro-entérologie [CHRU Nancy]
29 NuMeCan - Nutrition, Métabolismes et Cancer
30 CHU Pontchaillou [Rennes]
Philippe Seksik
  • Function : Author
  • PersonId : 990297
Stephanie Viennot
  • Function : Author
Matthieu Allez
Anthony Buisson
Laurianne Plastaras
  • Function : Author


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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Dates and versions

hal-03690498 , version 1 (30-06-2022)



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, 2022, 54 (10), pp.1350-1357. ⟨10.1016/j.dld.2022.04.011⟩. ⟨hal-03690498⟩
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