Real-world comparison of second-line infliximab and jak inhibitors for ulcerative colitis after first-line vedolizumab: A comparative multicenter study
Omer Shohat, Roni Weisshof, Ahinoam Glusman-Bendersky, Jacob E. Ollech, Henit Yanai, Uri Kopylov, Asaf LevartovskyBackground
Vedolizumab (VDZ) is increasingly used as a first-line biologic therapy for moderate-to-severe ulcerative colitis (UC), but evidence on second-line treatment efficacy following VDZ first-line treatment is lacking.
Objectives
Real-World Comparison of second-line infliximab and jak inhibitors for ulcerative colitis after first-line vedolizumab.
Design
This multicenter retrospective observational cohort study included UC patients who received VDZ as first-line therapy followed by second-line treatment with infliximab, tofacitinib, or upadacitinib. The primary outcomes were clinical response and remission at week 26. Secondary outcomes included week 52 clinical response, remission, and drug persistence.
Methods
We included 92 patients treated with VDZ as first-line biologic therapy followed by second-line therapy (58 infliximab, 34 JAK inhibitors).
Results
At week 26, no significant difference was observed between infliximab and JAK inhibitors for clinical response (50% vs. 47%, p = 0.79) and clinical remission (33% vs. 41%), respectively (p = 0.42). In a multivariable logistic regression model adjusting for predefined clinical covariates, treatment group was not significantly associated with week 26 clinical response or remission. Four patients (4.3%) experienced an adverse event leading to treatment discontinuation (2 infliximab, 2 JAK inhibitors).
Conclusion
Following first-line VDZ treatment in patients with UC, no statistically significant differences in clinical effectiveness, persistence, or safety outcomes were observed between infliximab and JAK inhibitors.