Clinical effectiveness and safety of vedolizumab versus infliximab in biologic-naïve patients with ulcerative colitis: A comparative real-world multicentric observational study.

IF 2.2 4区 医学 Q3 GASTROENTEROLOGY & HEPATOLOGY
Sandro da Costa Ferreira, Rogério Serafim Parra, Ligia Yukie Sassaki, José Miguel Luz Parente, Munique Kurtz de Mello, Liliana Andrade Chebli, Rafael Luís Luporini, Antonio José Tiburcio Alves Junior, Fernando Jorge Firmino Nóbrega, Bruno César da Silva, Eron Fábio Miranda, Abel Botelho Quaresma, Guilherme Mattioli Nicollelli, Rodrigo Galhardi Gasparini, Renata de Medeiros Dutra, Juarez Roberto de Oliveira Vasconcelos, Katia da Conceição da Silva, Daniéla Oliveira Magro, Marcello Rabello Imbrizi, Cristiane Kibune Nagasako, Omar Féres, Luiz Ernesto de Almeida Troncon, Paulo Gustavo Kotze, Júlio Maria Fonseca Chebli
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引用次数: 0

Abstract

Objective: Vedolizumab (VDZ) and infliximab (IFX) are first-line therapies for moderate-to-severe ulcerative colitis (UC). Despite their widespread use, there are no direct comparative studies, and real-world data, particularly in Latin America, are limited. This study compared the effectiveness and safety of VDZ and IFX in biologic-naïve UC patients.

Methods: This retrospective cohort study included patients with moderate-to-severe UC (Mayo score 6-12, endoscopic sub-score ≥2) treated with VDZ or IFX. Primary endpoints were clinical remission (partial Mayo score ≤2), endoscopic remission (Mayo sub-score=0), and steroid-free clinical remission at week 52. Secondary endpoints included clinical response, endoscopic response, biological therapy optimization, adverse events (AEs), hospitalizations, and biochemical remission at week 52. Propensity score adjustment (1/PS) was used to adjust for potential confounders.

Results: A total of 297 UC patients (156 IFX, 141 VDZ) were analyzed. Clinical remission at week 52 was 82.3% for VDZ and 77.6% for IFX (p=0.11), while endoscopic remission was higher in VDZ patients (47.4% vs. 33.1%, p=0.03). Steroid-free clinical remission rates were similar between groups (p=0.98). Endoscopic response at week 52 favored VDZ (78.4% vs. 62.7%, p<0.001), and VDZ had higher treatment persistence (80.8% vs. 61.8%, p<0.001). AEs and hospitalizations were more frequent in IFX patients (p<0.001).

Conclusions: Both VDZ and IFX are effective in biologic-naïve UC patients, however VDZ demonstrated superior endoscopic outcomes, higher treatment persistence, and a better safety profile, supporting its use as a first-line therapy.

vedolizumab与英夫利昔单抗在biologic-naÏve溃疡性结肠炎患者中的临床有效性和安全性:一项比较真实世界的多中心观察性研究
目的:Vedolizumab (VDZ)和英夫利昔单抗(IFX)是治疗中重度溃疡性结肠炎(UC)的一线药物。尽管它们被广泛使用,但没有直接的比较研究,而且真实世界的数据,特别是在拉丁美洲,是有限的。本研究比较了VDZ和IFX在biologic-naïve UC患者中的有效性和安全性。方法:本回顾性队列研究纳入了接受VDZ或IFX治疗的中重度UC (Mayo评分6-12分,内镜亚评分≥2分)患者。主要终点为临床缓解(部分Mayo评分≤2)、内镜下缓解(Mayo亚评分= 0)和第52周无类固醇临床缓解。次要终点包括临床反应、内镜反应、生物治疗优化、不良事件(ae)、住院和第52周生化缓解。倾向评分调整(1/PS)用于调整潜在混杂因素。结果:共分析297例UC患者(IFX 156例,VDZ 141例)。第52周,VDZ组的临床缓解率为82.3%,IFX组为77.6% (p = 0.11),而VDZ组的内窥镜缓解率更高(47.4%比33.1%,p = 0.03)。两组无类固醇临床缓解率相似(p = 0.98)。第52周的内镜反应有利于VDZ(78.4%比62.7%,p < 0.001),并且VDZ具有更高的治疗持久性(80.8%比61.8%,p < 0.001)。不良事件和住院在IFX患者中更为常见(p < 0.001)。结论:VDZ和IFX对biologic-naïve UC患者都有效,但VDZ表现出更好的内镜结果,更高的治疗持久性和更好的安全性,支持其作为一线治疗。
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来源期刊
Gastroenterologia y hepatologia
Gastroenterologia y hepatologia GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
1.50
自引率
10.50%
发文量
147
审稿时长
48 days
期刊介绍: Gastroenterology and Hepatology is the first journal to cover the latest advances in pathology of the gastrointestinal tract, liver, pancreas, and bile ducts, making it an indispensable tool for gastroenterologists, hepatologists, internists and general practitioners.
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