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Diabetes

Session: Poster Session B

(040) Comparative Effectiveness of Anti-TNF Therapy and Vedolizumab in Crohn's Disease Patients

Tuesday, August 27, 2024
8:00 AM – 6:00 PM CEST
Location: Convention Hall II

    Presenting Author(s)

  • Nai-Yu Chen, PhD

    PhD Research Assistant
    1. Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Taiwan (Republic of China)

    • Co-Author(s)

  • YC

    Yung-Ting Chiu

    1. Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Taiwan (Republic of China)

  • CC

    Chiao-Hsiung Chuang

    3. Department of Internal Medicine, Medical College and Hospital, National Cheng Kung University, Tainan, Taiwan, Taiwan (Republic of China)

  • YC

    Yu-Ching Chang

    4. Health Outcome Research Center, National Cheng Kung University, Tainan, Taiwan, Taiwan (Republic of China)

  • CC

    Ching-Lan Cheng

    Associate Professor
    Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Taiwan (Republic of China)

Background: Although there are several biologic therapies for Crohn's disease (CD), understanding their comparative effectiveness is difficult due to limited data. Our study aims to fill this knowledge gap by using real-world data to explore various treatment outcomes.

Objectives: To compare the effectiveness of TNF inhibitors and vedolizumab in the treatment of Crohn's disease patients.

Methods: This study utilized Taiwan's National Health Insurance database and included adult CD patients aged 20 years and above with CD who received either anti-TNF therapy or vedolizumab. Propensity score matching was employed to adjust for baseline characteristics, ensuring comparability between the two groups. The primary outcome was a composite endpoint consisting of CD-related hospitalizations, emergency visits, or surgeries, while the secondary outcome was the need for blood transfusions. The observation period lasted for one year. We used a Cox proportional hazards model to estimate Hazard Ratios (HR) along with their corresponding 95% confidence intervals (CI).

Results: After conducting propensity score matching, each group consisted of 108 patients. In the analysis of composite endpoints, vedolizumab showed an elevated risk compared to anti-TNF therapy, with an adjusted HR of 1.61 (95% CI 1.04-2.50). Subgroup analysis yielded consistent results for CD-related hospitalization or emergency visits. However, the risk of surgery was higher with vedolizumab, though it did not reach statistical significance. Concerning secondary outcomes, vedolizumab was associated with an increased likelihood of requiring blood transfusions, though this association did not reach statistical significance (adjusted HR=1.24; 95% CI 0.51-3.05).

Conclusions: This study findings suggest that in managing Crohn's disease, anti-TNF therapy exhibits greater effectiveness when compared to vedolizumab. Further research could explore the long-term effects of biologic treatments, providing a better understanding of how they affect patients' quality of life.