Proceedings (Baylor University. Medical Center) · 2026
Comparative efficacy of ustekinumab and vedolizumab in anti-TNF-naive and anti-TNF-exposed patients with Crohn's disease: a matched cohort study.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Eldesouki Mohamed H, Elfert Khaled, Ibrahim Ahmed, Rabea Eslam M, Elsharkawy Muhammad M, Aldemerdash Mohamed A, Obeng George, Tandon Kanwarpreet, Hadam-Veverka Jennifer
Аннотация
BACKGROUND: Ustekinumab and vedolizumab are used in patients with Crohn's disease (CD). However, comparative studies evaluating their long-term efficacy in anti-TNF-naïve and anti-TNF-exposed populations remain limited.
METHODS: A retrospective cohort study utilizing the TriNetX US Collaborative Network database was conducted to compare the real-world efficacy of ustekinumab and vedolizumab in adult patients with CD. Patients were stratified into anti-TNF-naïve and anti-TNF-exposed cohorts, and 1:1 propensity score matching was employed. The primary outcome was rate of corticosteroid use at 12 and 24 months. Secondary outcomes included all-cause hospitalization rates and emergency department visits.
RESULTS: In the anti-TNF-naïve cohort (n = 2800 per group after matching), ustekinumab was associated with significantly lower steroid use at 12 months (29.8% vs 39.0%; adjusted hazard ratio [aHR] 0.71, 95% confidence interval [CI] 0.65-0.78; P < 0.001) and 24 months (36.1% vs 45.3%; aHR 0.73, 95% CI 0.68-0.80; P < 0.001). Ustekinumab was also associated with fewer emergency department visits, while hospitalization rates were slightly higher at 12 months but not significantly different at 24 months. In the anti-TNF-exposed cohort (n = 1234 per group after matching), ustekinumab was associated with lower steroid use at 12 months (43.7% vs 53.2%; aHR 0.73, 95% CI 0.66-0.82; P < 0.001) and 24 months (35.8% vs 45.3%; aHR 0.72, 95% CI 0.63-0.81; P < 0.001). Ustekinumab was also associated with fewer emergency department visits and reduced hospitalization rates at both time points.
CONCLUSIONS: Ustekinumab use was associated with lower corticosteroid exposure and reduced healthcare utilization compared to vedolizumab in anti-TNF-naïve and anti-TNF-exposed CD patients.
METHODS: A retrospective cohort study utilizing the TriNetX US Collaborative Network database was conducted to compare the real-world efficacy of ustekinumab and vedolizumab in adult patients with CD. Patients were stratified into anti-TNF-naïve and anti-TNF-exposed cohorts, and 1:1 propensity score matching was employed. The primary outcome was rate of corticosteroid use at 12 and 24 months. Secondary outcomes included all-cause hospitalization rates and emergency department visits.
RESULTS: In the anti-TNF-naïve cohort (n = 2800 per group after matching), ustekinumab was associated with significantly lower steroid use at 12 months (29.8% vs 39.0%; adjusted hazard ratio [aHR] 0.71, 95% confidence interval [CI] 0.65-0.78; P < 0.001) and 24 months (36.1% vs 45.3%; aHR 0.73, 95% CI 0.68-0.80; P < 0.001). Ustekinumab was also associated with fewer emergency department visits, while hospitalization rates were slightly higher at 12 months but not significantly different at 24 months. In the anti-TNF-exposed cohort (n = 1234 per group after matching), ustekinumab was associated with lower steroid use at 12 months (43.7% vs 53.2%; aHR 0.73, 95% CI 0.66-0.82; P < 0.001) and 24 months (35.8% vs 45.3%; aHR 0.72, 95% CI 0.63-0.81; P < 0.001). Ustekinumab was also associated with fewer emergency department visits and reduced hospitalization rates at both time points.
CONCLUSIONS: Ustekinumab use was associated with lower corticosteroid exposure and reduced healthcare utilization compared to vedolizumab in anti-TNF-naïve and anti-TNF-exposed CD patients.