Comparing Patient-Reported Outcomes Among Anti-TNF Experienced Patients With Ulcerative Colitis Initiating
Michael D Kappelman1, Millie D Long1, Xian Zhang1
1University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Crohn'S & Colitis 360
|June 23, 2023
Summary
In ulcerative colitis patients who failed anti-tumor necrosis factor (TNF) therapy, tofacitinib showed lower pain interference than vedolizumab. Further research is needed to confirm these findings in larger studies.
Area of Science:
- Gastroenterology
- Immunology
- Clinical Therapeutics
Background:
- Nonresponse to anti-tumor necrosis factor (TNF) therapy is frequent in ulcerative colitis (UC).
- Limited research compares subsequent biologic therapies after anti-TNF failure in UC.
- Patient-reported outcomes (PROs) are crucial for evaluating treatment effectiveness in UC.
Purpose of the Study:
- To compare the effectiveness of vedolizumab and tofacitinib in anti-TNF experienced UC patients.
- To focus on patient-prioritized outcomes, including pain and fatigue.
- To assess treatment persistence and colectomy rates as secondary outcomes.
Main Methods:
- Prospective cohort study within IBD Partners and SPARC IBD initiatives.
- Compared UC patients initiating vedolizumab or tofacitinib after anti-TNF therapy.
- Analyzed PROs (PROMIS Fatigue, Pain Interference, PRO2) at ~6 months post-initiation.
Main Results:
- Tofacitinib initiators reported significantly lower Pain Interference compared to vedolizumab initiators (P=.04).
- No significant difference was observed in Fatigue (P=.53) between the groups.
- Secondary outcomes, including PRO2, treatment persistence, and colectomy rates, did not differ significantly.
Conclusions:
- Tofacitinib may offer better pain relief than vedolizumab in anti-TNF experienced UC patients.
- Some secondary outcomes favored tofacitinib, but larger studies are required.
- Further investigation is needed to validate these findings and understand long-term efficacy.
Keywords:
Ulcerative colitiscomparative effectiveness researchpatient-reported outcomestofacitinibvedolizumabMore Related Videos
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