Vedolizumab vs TNF Antagonist: Which is Best for Ulcerative Colitis?

Patients with ulcerative colitis (UC) who are treated with vedolizumab saw higher rates of remission than those treated with tumor necrosis factor (TNF) antagonists, according to data presented at Digestive Disease Week.

The researchers conducted a multicentered study using propensity score matching (1:1) accounting for age, sex, prior UC-related hospitalization, disease extent and severity, steroid refractoriness or dependence, and prior TNF-antagonist failure. Rates of clinical remission, steroid-free remission, and endoscopic healing were compared using Cox proportional hazard models.

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Overall, 167 participants were assigned to vedolizumab and 167 were assigned to anti-TNF therapy.

Patients in the vedolizumab cohort had higher rates of clinical remission (54% vs 37%, adjusted hazard ratio [aHR] 1.54). and endoscopic healing (50% vs. 42%; aHR= 1.73) compared with those in the anti-TNF group after 12 months of treatment. Steroid-free remission rates were higher among those in the vedolizumab group (49% vs. 38%; aHR = 1.43).

“After accounting for measurable disease and patient-specific characteristics that may impact biologic effectiveness, we observed that vedolizumab -treated UC patients had significantly higher 12-month cumulative rates of clinical remission and endoscopic healing, and numerically higher steroid-free remission rates, when compared to TNF-antagonist–treated patients,” the researchers concluded.

—Michael Potts

Reference:

Comparative effectiveness of vedolizumab and tumor necrosis factor-antagonist therapy in ulcerative colitis: a multicenter consortium propensity score-matched analysis [presented at Digestive Disease Week 2018]. June 3, 2018. Washington, DC.