20.500.12556/DiRROS-24481 First-line anti-TNF agents, ustekinumab and vedolizumab perform similarly in Crohn' disease, but not in ulcerative colitis Background: 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. anti-TNF agents ustekinumab vedolizumab true false true Angleški jezik Ni določen V članku navedeno Copyright © 2025 The Author(s). Na pristajalni strani članka je navedena licenca: Creative Commons CC-BY-NC-ND. Neznano 2025-12-01 14:05:19 2025-12-01 14:05:19 2025-12-02 03:42:04 0000-00-00 00:00:00 2025 0 0 Nasl. z nasl. zaslona; Opis vira z dne 20. 2. 2025; str. 557-564 no. 5 Vol. 37 May 2025 0000-00-00 Zaloznikova Objavljeno apc 0000-00-00 0000-00-00 0000-00-00 61 1473-5687 10.1097/MEG.0000000000002940 226849539 RAZ_Supovec_Eva_2025.pdf RAZ_Supovec_Eva_2025.pdf 1 14705A3FAAC88426C8B2F1228AAD8B52 e719c0dcff6b8b0368db65bb4e0865330fe2503d601f3d2456bf225373a973e5 804a6f55-ceb7-11f0-94a7-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=36479 https://journals.lww.com/eurojgh/fulltext/2025/05000/first_line_anti_tnf_agents,_ustekinumab_and.5.aspx 1 648fcb0a-ceb6-11f0-94a7-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=36478 Univerzitetni klinični center Ljubljana 0 0 0