Vedolizumab and anti-TNF therapies: a real-world comparison

In a real-world comparison of vedolizumab and anti-TNF therapies in biologic-naïve ulcerative colitis (UC) patients, vedolizumab was associated with higher persistence, lower likelihood of exacerbations and a better safety profile [1]. However, sample size limitations necessitate further study.

The EVOLVE study is one of the first to compare a biological with anti-TNF as early treatment of UC. It was a real-world, multi-country, retrospective chart review study in Canada, Greece, and the USA. The clinical effectiveness and safety of vedolizumab or an anti-TNF (adalimumab, infliximab, or golimumab) as a first-line biologic initiated within 2 years after diagnosis were assessed. A total of 176 UC patients from 37 sites were included in the analysis: 86 using vedolizumab and 90 using anti-TNF. The mean age in both groups was 41.4 and 36.8 years, respectively. The proportion of men was 58.1% and 56.7%, respectively.

At 12 months, 72.9% and 58.1% still used vedolizumab and anti-TNF respectively (P=0.03). There were no differences in clinical response, clinical remission, or mucosal healing. However, vedolizumab users had a significantly lower risk of UC exacerbations (HR 0.47; 95% CI 0.32–0.69) and serious adverse events (HR 0.37; 95% CI: 0.19–0.72). The authors concluded that, based on these findings, early treatment with vedolizumab may improve long-term clinical outcomes.

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   1. Mantzaris G, et al. ECCO-IBD 2020, DOP55.

Posted on 14 April 202012 November 2020