Superior effectiveness of tofacitinib compared to vedolizumab in anti-TNF experienced ulcerative colitis patients:a nationwide Dutch Registry study

Background & Aims: Clinicians face difficulty in when and in what order to position biologics and Janus kinase inhibitors in patients with anti-tumor necrosis factor-alpha (TNF) refractory ulcerative colitis (UC). We aimed to compare the effectiveness and safety of vedolizumab and tofacitinib in anti-TNF-exposed patients with UC in our prospective nationwide Initiative on Crohn and Colitis Registry. Methods: Patients with UC who failed anti-TNF treatment and initiated vedolizumab or tofacitinib treatment were identified in the Initiative on Crohn and Colitis Registry in the Netherlands. We... Mehr ...

Verfasser: Straatmijer, Tessa
Biemans, Vince Bc
Visschedijk, Marijn
Hoentjen, Frank
de Vries, Annemarie
van Bodegraven, Adriaan A
Bodelier, Alexander
de Boer, Nanne K H
Dijkstra, Gerard
Festen, Noortje
Horjus, Carmen
Jansen, Jeroen M
Jharap, Bindia
Mares, Wout
van Schaik, Fiona Dm
Ponsioen, Cyriel
Romkens, Tessa
Srivastava, Nidhi
van der Voorn, Michael Mpja
West, Rachel
van der Woude, Janneke
Wolvers, Marije D J
Pierik, Marieke
van der Meulen-de Jong, Andrea E
Duijvestein, Marjolijn
Dokumenttyp: Artikel
Erscheinungsdatum: 2023
Reihe/Periodikum: Straatmijer , T , Biemans , V B , Visschedijk , M , Hoentjen , F , de Vries , A , van Bodegraven , A A , Bodelier , A , de Boer , N K H , Dijkstra , G , Festen , N , Horjus , C , Jansen , J M , Jharap , B , Mares , W , van Schaik , F D , Ponsioen , C , Romkens , T , Srivastava , N , van der Voorn , M M , West , R , van der Woude , J , Wolvers , M D J , Pierik , M , van der Meulen-de Jong , A E , Duijvestein , M & Initiative on Crohn and Colitis 2023 , ' Superior effectiveness of tofacitinib compared to vedolizumab in anti-TNF experienced ulcerative colitis patients : a nationwide Dutch Registry study ' , Clinical gastroenterology and hepatology , vol. 21 , no. 1 , pp. 182-191.e2 . https://doi.org/10.1016/j.cgh.2022.04.038
Sprache: Englisch
Permalink: https://search.fid-benelux.de/Record/base-29021598
Datenquelle: BASE; Originalkatalog
Powered By: BASE
Link(s) : https://cris.maastrichtuniversity.nl/en/publications/e9b92ca8-f2d4-4162-a6a1-78beb2874677

Background & Aims: Clinicians face difficulty in when and in what order to position biologics and Janus kinase inhibitors in patients with anti-tumor necrosis factor-alpha (TNF) refractory ulcerative colitis (UC). We aimed to compare the effectiveness and safety of vedolizumab and tofacitinib in anti-TNF-exposed patients with UC in our prospective nationwide Initiative on Crohn and Colitis Registry. Methods: Patients with UC who failed anti-TNF treatment and initiated vedolizumab or tofacitinib treatment were identified in the Initiative on Crohn and Colitis Registry in the Netherlands. We selected patients with both clinical as well as biochemical or endoscopic disease activity at initiation of therapy. Patients previously treated with vedolizumab or tofacitinib were excluded. Corticosteroid-free clinical remission (Simple Clinical Colitis Activity Index ≤2), biochemical remission (C-reactive protein ≤5 mg/L or fecal calprotectin ≤250 μg/g), and safety outcomes were compared after 52 weeks of treatment. Inverse propensity score-weighted comparison was used to adjust for confounding and selection bias. Results: Overall, 83 vedolizumab- and 65 tofacitinib-treated patients were included. Propensity score-weighted analysis showed that tofacitinib-treated patients were more likely to achieve corticosteroid-free clinical remission and biochemical remission at weeks 12, 24, and 52 compared with vedolizumab-treated patients (odds ratio [OR], 6.33; 95% confidence interval [CI], 3.81–10.50; P < .01; OR, 3.02; 95% CI, 1.89–4.84; P < .01; and OR, 1.86; 95% CI, 1.15–2.99; P = .01; and OR, 3.27; 95% CI, 1.96–5.45; P < .01; OR, 1.87; 95% CI, 1.14–3.07; P = .01; and OR, 1.81; 95% CI, 1.06–3.09; P = .03, respectively). There was no difference in infection rate or severe adverse events. Conclusions: Tofacitinib was associated with superior effectiveness outcomes compared with vedolizumab in anti-TNF-experienced patients with UC along with comparable safety outcomes.