Abstract
Abstract Background Current literature presents conflicting findings about the efficacy of Infliximab (IFX) versus vedolizumab (VDZ) in patients with moderately to severely active ulcerative colitis (UC). Patients with UC who are positive for anti-neutrophil cytoplasmic antibodies(ANCA) are known to respond poorly to IFX1-3 and VDZ4. We aimed to evaluate the comparative efficacy and safety of IFX versus VDZ in moderately to severely active UC patients with Proteinase 3-ANCA(PR3-ANCA) positive. Methods This retrospective multicentre real-world study was conducted in three centers in Hubei, China. Patients with moderate to severe active ulcerative colitis (UC) who are positive for PR3-ANCA were allocated to either the Vedolizumab (VDZ) group (n=19) or the Infliximab (IFX) group (n=26) depending on the biologics they received. The endpoints assessed at week 22 included clinical remission(primary endpoint), clinical response, endoscopic response, and endoscopic remission. Inverse probability of treatment weighting (IPTW) was employed to ensure the reliability and robustness of the clinical outcomes. Results In the original cohort, IFX was not superior to VDZ in terms of clinical remission (23.08% vs. 42.11%, P=0.173), clinical response (65.38% vs. 63.16%, P=0.878), endoscopic response (57.69% vs. 63.16%, P=0.712), and endoscopic remission (11.54% vs. 26.32%, P=0.253). Additionally, similar outcomes were observed in the IPTW cohort: for clinical remission (23.26% vs. 35.89%, P=0.384), clinical response (68.68% vs. 60.29%, P=0.583), endoscopic response (58.48% vs. 60.29%, P=0.912), and endoscopic remission (14.18% vs. 22.75%, P=0.494) when comparing IFX to VDZ. Conclusion IFX is not superior efficacy compared to VDZ in moderately to severely active UC patients with PR3-ANCA positive.
Published Version
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