Comparing Patient-Reported Outcomes Among Anti-TNF Experienced Patients With Ulcerative Colitis Initiating Vedolizumab Versus Tofacitinib.

Background

Primary and secondary nonresponse to anti-tumor necrosis factor (TNF) therapy is common in patients with ulcerative colitis (UC), yet limited research has compared the effectiveness of subsequent biological therapy.

Objective

We sought to compare the effectiveness of vedolizumab and tofacitinib in anti-TNF experienced patients with UC, focusing on patient-prioritized patient-reported outcomes (PROs).

Methods

We conducted a prospective cohort study nested within the Crohn's & Colitis Foundation's IBD Partners and SPARC IBD initiatives. We identified anti-TNF experienced patients with UC initiating vedolizumab or tofacitinib and analyzed PROs reported approximately 6 months later (minimum 4 months, maximum 10 months). Co-primary outcomes were Patient Reported Outcome Measurement Information System (PROMIS) domains of Fatigue and Pain Interference. Secondary outcomes included PRO2, treatment persistence, and need for colectomy.

Results

We compared 72 vedolizumab initiators and 33 tofacitinib initiators. At follow-up, Pain Interference (

Conclusions

Among anti-TNF experienced patients with UC, Pain Interference 4-10 months after treatment initiation was lower among tofacitinib users as compared with vedolizumab users. Many, but not all, secondary endpoints and subanalyses also favored tofacitinib. Future studies with larger sample sizes are needed to further evaluate these findings.

Informations de copyright

© The Author(s) 2023. Published by Oxford University Press on behalf of Crohn's & Colitis Foundation.

Déclaration de conflit d'intérêts

M.D.K. has consulted for AbbVie, Janssen, Pfizer, Takeda, and Lilly, is a shareholder in Johnson & Johnson, and has received research support from Pfizer, Takeda, Janssen, AbbVie, Lilly, Genentech, Boehringer Ingelheim, Bristol Myers Squibb, Celtrion, and Arenapharm. M.D.L. consulting for AbbVie, Janssen, Pfizer, Takeda, Lilly, BMS, Prometheus, Target Pharmasolutions, Calibr, Roche, Genentech, Theravance, Research support Takeda, and Pfizer. X.Z., F.-C.L., L.W., W.C., J.B., C.M.B., V.N., A.F.K., and A.D. report no conflicts of interest. J.D. is a shareholder in Pfizer. L.E.P. is employed by HealthCore/Anthem. K.H. was employed by Anthem at the time of the research and is currently an employee of Janssen Research & Development. J.D.L. has served as a consultant for Janssen Pharmaceuticals, Samsung Bioepis, Bristol-Myers Squibb, Merck, Celgene, AbbVie, Entasis Therapeutics, and Bridge Biotherapeutics. J.D.L. has served as a paid member of a data monitoring committee for Pfizer, UCB, Gilead, Galapagos, Arena Pharmaceuticals, Protagonist Therapeutics, Sanofi, and Amgen. J.D.L. has received research funding from Janssen Pharmaceuticals, AbbVie, and Takeda Pharmaceuticals. J.D.L. has received educational grant funding from Takeda Pharmaceuticals and Janssen.