A study, published in Alimentary Pharmacology and Therapeutics, examined the efficacy and safety of different therapies for the treatment of ulcerative colitis.
Siddharth Singh, MD, of UC San Diego, and colleagues identified randomized controlled trials involving adults with moderate-to-severe ulcerative colitis treated with anti-tumour necrosis factor agents, anti-integrin agents and janus kinase inhibitors.
Here's what they found:
1. Infliximab and vedolizumab were the best treatments at inducing clinical remission and mucosal healing.
2. In patients who were exposed to anti-TNF therapies, tofacitinib was best at inducing clinical remission and mucosal healing.
3. Vedolizumab was the safest therapy. It had the lowest rate of severe adverse events and infections.
Researchers concluded, "Infliximab and vedolizumab are ranked highest as 1st-line agents, and tofacitinib is ranked highest as a 2nd-line agent, for induction of remission and mucosal healing in patients with moderate-severe UC, based on indirect comparisons. Head-to-head trials are warranted to inform clinical decision-making with greater confidence."
Researchers said differences in trial design limited their ability to compare trials in terms of efficacy for maintenance therapies.