Anti-TNFs Outperform Other Biologics for Endoscopic Healing in Crohn Disease

Adalimumab and infliximab resulted in higher rates of endoscopic healing after 1 year of therapy for moderate to severe Crohn disease than vedolizumab and ustekinumab, according to study results published online ahead of print in The American Journal of Gastroenterology.

The comparative effectiveness analysis pooled patient-level data for 299 patients from 4 clinical trials.

Rates of 1-year complete endoscopic healing were superior with adalimumab (27.9%) and infliximab (27.7%) compared with vedolizumab (7.1%), reported researchers, who added that differences were not significant between vedolizumab and ustekinumab.

The study identified no significant differences between biologics for 1-year ileal endoscopic healing among patients with baseline ileal Simple Endoscopic Score for Crohn Disease (SES-CD) scores of 3 or greater. But for patients with ileal ulcers larger than 0.5 cm, 1-year rates of no ileal ulcers were 40.8% with infliximab compared with 8.7% with vedolizumab.

Rates of 1-year endoscopic healing in the colon were superior with adalimumab (62.5%) compared with ustekinumab (29.0%), researchers reported, with similar trends for infliximab (52.4%).

“In this post-hoc analysis,” they concluded, “TNFα antagonists were overall superior to vedolizumab and ustekinumab for achieving 1-year endoscopic healing in moderate-severe Crohn’s disease patients.”

—Jolynn Tumolo

Reference:
Narula N, Wong ECL, Dulai PS, Marshall JK, Jairath V, Reinisch W. Comparative effectiveness of biologics for endoscopic healing of the ileum and colon in Crohn’s disease. Am J Gastroenterol. Published online ahead of print, April 15, 2022.