Entyvio linked with lower risk for non-infectious adverse events in Crohn’s
Entyvio yielded a lower risk for non-infectious serious adverse events than TNF antagonist therapy in Crohn’s disease, according to a study published in Alimentary Pharmacology and Therapeutics.
However, the same was not true regarding serious infections. Further, there was no significant difference in achievement of disease remission between Entyvio (vedolizumab, Takeda) and TNF antagonist therapy.
“Post-hoc secondary analyses observed a significant difference between vedolizumab and TNF-antagonist therapy for the risk of non-infectious adverse events specifically, which remained after accounting for differences in the duration of follow-up, but not the risk of serious infections between vedolizumab monotherapy and TNF-antagonist monotherapy,” Matthew W. Bohm, DO, from Indiana University Health and colleagues wrote.
The researchers added, “Subgroup analysis also suggested that vedolizumab might be favored in early-disease CD, but along these same lines TNF-antagonist therapy may be favored in later-stage CD.”
Bohm and colleagues performed a retrospective observational study of 1,266 patients with Crohn’s disease who were given either vedolizumab (n = 659) or TNF-antagonist therapy such as Remicade (infliximab, Janssen; n = 305) or subcutaneous TNF-antagonist agents (n = 302). Investigators weighted propensity scores for age, prior treatments, disease complications, extent and severity, steroid dependence and concomitant immunosuppressive drug use. Comparative risk for infections or non-infectious serious adverse events served as the primary outcome. Other comparative effectives outcomes included clinical remission, steroid-free clinical remission and endoscopic remission.
Investigators found the rate of non-infectious serious adverse events (OR = 0.072; 95% CI, 0.0120.242), compared with serious infections (OR = 1.183; 95% CI, 0.7861.795), was lower with vedolizumab compared with TNF-antagonist therapy. After adjusting for differences in duration of exposure, the safety comparisons for non-infectious serious adverse events remained significant. Clinical remission (HR = 0.932; 95% CI, 0.707-1.228), steroid-free clinical remission (HR = 1.25; 95% CI, 0.677-2.31) and endoscopic remission (HR = 0.827; 95% CI, 0.595-1.151) were not different between use of vedolizumab or TNF-antagonist therapy. TNF-antagonist therapy compared with vedolizumab was correlated with higher treatment persistence.