Vedolizumab safer than anti-TNFs for older IBD patients

In the treatment of older patients with inflammatory bowel disease (IBD), vedolizumab is linked to a lower risk of infection-related hospitalization compared with antitumour necrosis factor-α (anti-TNF) agents, according to a study.

Researchers conducted a retrospective IBD cohort study involving 1,152 new users of anti-TNF and 480 new users of vedolizumab. All patients were aged ≥65 years. The primary safety endpoint was infection-related hospitalization (excluding intra-abdominal and perianal abscesses). Treatment efficacy was also estimated by evaluating IBD-related hospitalization, IBD-related surgery, and new corticosteroid use ≥60 days after biologic initiation.

Both cohorts had a median age of 71 years, with 11 percent being ≥80 years of age. A total of 54 percent of patients in the anti-TNF cohort and 57 percent of those in the vedolizumab cohort had Crohn’s disease.

There were no significant between-group differences observed in demographics, healthcare utilization, and frailty. More than half of the patients in both cohorts had comorbidities, with a Charlson comorbidity index of ≥2.

In an analysis that applied propensity score weighting and standardized morbidity ratio-weighted variables, the risk of infection-related hospitalization was significantly lower among vedolizumab users vs anti-TNF users (adjusted hazard ratio 0.47, 95 percent confidence interval, 0.25–0.86).

Efficacy outcomes did not significantly differ between the two cohorts.