AI Article Synopsis
- - This study compares the effectiveness of ozanimod and vedolizumab as first-line treatments for ulcerative colitis (UC) using a large US database, focusing on their impacts over a 12-month period.
- - After analyzing 222 patients on ozanimod and 4145 on vedolizumab, results indicated no significant differences in corticosteroid usage between the two groups, but a higher likelihood of changing therapy was observed in the ozanimod group.
- - Overall, the findings suggest that while ozanimod might be equally effective in managing corticosteroid needs, it presents a greater risk for changing treatment compared to vedolizumab, highlighting the need for more research on long-term effects.
Article Abstract
Introduction: There is limited real-world evidence comparing the effectiveness of ozanimod to vedolizumab as first-line advanced therapies in patients with ulcerative colitis (UC).
Methods: We conducted a retrospective cohort study using TriNetX, a multi-institutional US database in adults with UC who were initiated on ozanimod compared to vedolizumab between January 1, 2021 and 22 June, 2024. The primary outcome was to compare the risk of a composite outcome of corticosteroid use, colectomy, or change to another advanced therapy between the 2 cohorts within 12 months. 1:1 propensity score matching (PSM) was performed for demographics, comorbid conditions, disease extent, laboratory parameters, and previous corticosteroid use. The risk was expressed as an adjusted odds ratio (aOR) with 95% CIs.
Results: We identified 222 patients in the ozanimod cohort (mean age 41.2 ± 15.7, 46.3% male sex, 68% White, and 22.5% ulcerative proctitis), and 4145 patients in the vedolizumab cohort (mean age 47.4 ± 18.3, 45.2% male sex, 69.7% White, and 17.2% ulcerative proctitis). After PSM, there was no significant difference in the risk of the composite outcome (aOR 0.92, 95% CI, 0.63-1.36) and corticosteroid use (aOR 0.80, 95% CI, 0.53-1.18) between the 2 cohorts within 12 months. There was a higher risk of change in therapy in the ozanimod cohort (aOR 1.95, 95% CI, 1.09-3.49) compared to the vedolizumab cohort. Colectomy rates were low in both cohorts (<0.04%).
Conclusions: Our real-world study showed that ozanimod use is associated with similar corticosteroid use but higher odds of a change in therapy compared to vedolizumab when used as first-line therapy in patients with UC. Further prospective studies are needed to understand long-term outcomes.
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| http://dx.doi.org/10.1093/ibd/izae251 | DOI Listing |
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