Vedolizumab outperforms anti-TNF in biologic-naïve ulcerative colitis

After 1 year of maintenance therapy, vedolizumab demonstrated higher clinical response rates than anti-TNF therapy in biologic-naive participants with ulcerative colitis (UC). Also, the treatment persistence was higher for vedolizumab therapy than for anti-TNF therapy, results from the real-world evidence, head-to-head VEDO-IBD study showed. Therefore, vedolizumab may be suggested as first-line biologic therapy in patients with UC.

The VEDO-IBD study (NCT03375424) was conducted to compare vedolizumab and anti-TNF therapies head-to-head in biologic-naïve and biologic-experienced patients with UC (n=1,200). The real-world evidence induction study included 314 biologic-naïve participants who were treated according to the physician’s preference and reported comparable response rates among vedolizumab receivers (51.8%) and anti-TNF receivers (54.2%). The 1-year follow-up analysis conducted by Dr Bernd Bokemeyer (University Hospital Schleswig-Holstein, Germany) and colleagues included 274 biologic-naïve participants with UC [1]. Clinical response^a rate and clinical remission^b rates were measured.

At week 52, treatment persistence was higher among vedolizumab receivers (83.5%) than among anti-TNF receivers (59.5%; P<0.001). In addition, the modified intention-to-treat analysis showed a higher response rate for participants treated with vedolizumab compared with participants treated with anti-TNFs (61.7% vs 40.3%; OR 2.39; 95% CI 1.39–4.10). In addition, the clinical remission rates (38.2% vs 26.0%) and corticosteroid-free remission rates (36.5% vs 24.0%) were not significant in participants treated with vedolizumab. Furthermore, both treatment groups displayed a significant improvement in quality of life from baseline but no difference in improvement of quality of life was observed between treatment groups.

Dr Bokemeyer concluded that the long-term results of this study show that vedolizumab is associated with a higher treatment persistence and a slightly higher effectiveness than anti-TNFs, suggesting that vedolizumab may be the preferred biologic therapy in biologic-naïve patients with UC.

a. Clinical response is defined as a reduction of partial Mayo score from baseline to 1-year by >3 points or a reduction of at least 30% compared with baseline or reaching remission at 1-year.

b. Clinical remission is defined as a partial Mayo score ≤1 plus a bleeding subscore of 0 and no systemic use of steroids or budesonide at 1-year.

1. Plachta-Danielzik S, et al. Maintenance phase propensity score adjusted effectiveness and persistence at week-52 in biologic-naïve Ulcerative Colitis patients treated with vedolizumab or anti-TNF (VEDO IBD-study). OP17, ECCO 2022, 16–19 February.

Copyright ©2022 Medicom Medical Publishers



Posted on 12 April 20228 April 2024