Background: The clinical effectiveness of vedolizumab (VDZ), a gut-selective anti-integrin antibody used to treat patients with moderately-to-severely active IBD, was compared with that of the tumor necrosis factor antagonist infliximab (IFX). Methods: Biologic-naïve patients treated with VDZ or IFX between 05/2014 and 02/2016 were identified in the US Explorys Universe database. Date of first infusion was taken as index date. The analysis was conducted amongst patients who were: aged ≥18 years at index; had ≥365 days of medical history prior to index (baseline); had successfully completed induction therapy (≥3 infusions ≤98 days of index); had 365 days of follow-up after index. VDZ initiators were matched to IFX initiators using propensity scores. Kaplan–Meier estimates were used to compare: (1) median (interquartile range [IQR]) time to discontinuation of index therapy (defined as the first of either no receipt of biologic ≤90 days of previous infusion or switch to another biologic); (2) IBD-related hospitalizations; and (3) flares (defined as use of intravenous steroids). Results: 105 VDZ initiators were matched to 315 IFX initiators (Table 1). Median time since diagnosis was 2.4 years for VDZ initiators and 1.9 years for IFX initiators. Median time to discontinuation was 244 days for both treatments, with VDZ and IFX IQRs of 194–307 and 190–300 days, respectively. Median time to first IBD-related hospitalization was 153 (IQR: 78–209) for VDZ initiators vs 98 (IQR: 45–168) days for IFX initiators; median time to first IBD-related flare was 111 (IQR: 40–226) days for VDZ initiators vs 93 (IQR: 35–182) days for IFX initiators. Conclusion: In biologic-naïve patients, there was a trend toward prolonged time to first IBD-related hospitalization or flare with VDZ versus IFX. Time to discontinuation was similar between the therapies. Further studies in larger cohorts and/or with longer follow-up times are needed to better understand the potential benefits of VDZ vs IFX.
