First-line anti-TNF agents, ustekinumab and vedolizumab perform similarly in Crohn' disease, but not in ulcerative colitisSupovec, Eva (Avtor) Hanžel, Jurij (Avtor) Novak, Gregor (Avtor) Manevski, Damjan (Avtor) Štabuc, Borut (Avtor) Drobne, David (Avtor) anti-TNF agentsustekinumabvedolizumabBackground: Real-word comparisons between first-line biologicals in inflammatory bowel disease (IBD) are scarce. Aims: The aim of this study is to compare drug persistence and patient reported outcome-2 (PRO-2) remission rates of first-line biological classes [anti-tumor necrosis factor (TNF) agents vs anti-integrin vedolizumab vs IL-12/23 inhibitor ustekinumab] in real life cohort. Methods: Individual level data of 946 adults (588 Crohn's disease and 358 ulcerative colitis) were retrieved from UR-CARE IBD platform. Adjusted drug survival curves using a pooled logistic model and PRO-2 remission rates for each class of biologicals were calculated and compared. Results: In Crohn's disease, no differences in drug survival were observed for anti-TNF agents vs vedolizumab vs ustekinumab as estimated survival with 95% confidence intervals were 0.81 (0.77-0.84) vs 0.89 (0.82-0.96) vs 0.88 (0.79-0.97) at year 1 and 0.52 (0.46-0.58) vs 0.58 (0.37-0.78) vs 0.58 (0.39-0.77) at year 4. In ulcerative colitis, however, anti-TNF agents had shorter drug survival than vedolizumab with estimated drug survival with 95% confidence intervals 0.60 (0.52-0.67) vs 0.76 (0.67-0.84) at year 1 and 0.37 (0.30-0.44) vs 0.50 (0.36-0.64) at year 4. No differences in PRO-2 remission rates were observed between drug classes in Crohn's disease (P = 0.95), but more patients enjoyed PRO-2 remission in ulcerative colitis treated with anti-TNF agents compared to vedolizumab (94.8 vs 78.9%, P = 0.002). Conclusion: Our real-world data suggest similar drug persistence and efficacy of first-line treatments with anti-TNF agents, vedolizumab and ustekinumab in Crohn's disease. In ulcerative colitis, however, drug persistence was higher for vedolizumab compared to anti-TNF agents, but on the cost of lower PRO-2 remission rates.20252025-12-01 14:05:19Neznano24481slV članku navedeno Copyright © 2025 The Author(s). Na pristajalni strani članka je navedena licenca: Creative Commons CC-BY-NC-ND.