Vedolizumab Tested Against TNF Antagonists in UC

Patients with ulcerative colitis (UC) who were treated with the anti-integrin therapeutic vedolizumab were more likely than patients treated with tumor necrosis factor (TNF) inhibitors to achieve clinical remission as well as steroid-free clinical remission and steroid-free deep remission, according to the results of a new study.

Researchers conducted a retrospective, multicenter observational study of 722 patients with UC who were treated either with vedolizumab (n = 454) or an anti-TNF agent (n = 268) from May 2014 through December 2017.  The study team used propensity score weighted comparisons to identify serious adverse events and the achievement of clinical remission, steroid-free clinical remission, and steroid-free deep remission.

The results revealed that patients treated with vedolizumab were more likely to achieve clinical remission (hazard ratio [HR], 1.651; 95% confidence interval [CI], 1.229-2.217); steroid-free clinical remission (HR, 1.828; 95% CI, 1.135-2.944); and steroid-free deep remission (HR, 2.819; 95% CI, 1.496-5.310) than patients treated with anti-TNF therapeutics. The results remained consistent for patients who were anti-TNF-naïve and those who had been treated previously with an anti-TNF agent, and for comparisons of patients who received vedolizumab vs infliximab and vs subcutaneous TNF-antagonist agents separately.

No statistically significant differences were found in the risk of serious adverse events (HR, 0.899; 95% CI, 0.502-1.612) or serious infections (HR, 1.235; 95% CI, 0.608-2.511) among patients treated with vedolizumab and those treated with TNF antagonists. However, the researchers noted, for patients who were anti-TNF naïve, vedolizumab was less likely to be associated with serious adverse events than TNF antagonists (HR, 0.192; 95% CI, 0.049-0.754).

“Treatment of ulcerative colitis with vedolizumab is associated with higher rates of remission than treatment with TNF-antagonist therapy in routine practice, and lower rates of serious adverse events in TNF-antagonist−naïve patients,” the researchers concluded.

--Rebecca Mashaw

Reference:

Lukin D, Faleck D, Xu R. Comparative safety and effectiveness of vedolizumab to tumor necrosis factor antagonist therapy for ulcerative colitis. Clin Gastroenterol Hepatol. Article in Press published online October 8, 2020. DOI: https://doi.org/10.1016/j.cgh.2020.10.004