{"doi":"10.1093/ecco-jcc/jjae188","title":"Tofacitinib Versus Vedolizumab Among Bio-naive Patients With Ulcerative Colitis: A Real-World Propensity-Weighted Comparison","abstract":"<jats:title>Abstract</jats:title>\n               <jats:sec>\n                  <jats:title>Background and Aims</jats:title>\n                  <jats:p>Over the last decade, treatment options for moderate-to-severe ulcerative colitis (UC) have expanded. However, comparative studies between these agents are limited, especially among biologic-naive patients. We aimed to compare the persistence, effectiveness, and safety of tofacitinib and vedolizumab as the first advanced treatment for patients with UC.</jats:p>\n               </jats:sec>\n               <jats:sec>\n                  <jats:title>Methods</jats:title>\n                  <jats:p>Patients who received either tofacitinib or vedolizumab as their first advanced therapy for UC in NHS Lothian were included. We used inverse probability of treatment weighting. The probability of treatment assignment was calculated via logistic regression using age, sex, UC duration, Montreal extent, C-reactive protein, concomitant corticosteroids, and partial Mayo score at drug commencement.</jats:p>\n               </jats:sec>\n               <jats:sec>\n                  <jats:title>Results</jats:title>\n                  <jats:p>We included n = 158 patients, of whom n = 81 (51.3%) received vedolizumab and n = 77 (48.7%) tofacitinib. Median follow-up for vedolizumab patients was 3.1 years (interquartile range [IQR] 1.6-4.8) and for tofacitinib patients 1.5 years (IQR 0.3-2.3). The cohort was 59.5% male with a median age of 41.1 years (IQR 31.5-51.8). At 2 years, vedolizumab persistence was superior to tofacitinib (p = 0.005). At Weeks 12 and 52, clinical, biochemical, and fecal biomarker steroid-free remission were comparable between groups. Primary nonresponse and secondary loss of response were 9.9% and 17.3% for vedolizumab and 23.4% and 13% for tofacitinib, respectively. The frequency of adverse events was comparable (11 [13.6%] vedolizumab vs 19 [24.7%] tofacitinib, p = 0.629).</jats:p>\n               </jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions</jats:title>\n                  <jats:p>We found that the persistence and tolerability of vedolizumab were superior to tofacitinib in bio-naive UC, although the rates of clinical and biomarker remission were comparable. These data may help inform the positioning of advanced therapy.</jats:p>\n               </jats:sec>","journal":"Journal of Crohn's and Colitis","year":2025,"id":637722,"datarank":0.16479184330021646,"base_score":1.0986122886681096,"endowment":1.0986122886681096,"self_citation_contribution":0.16479184330021646,"citation_network_contribution":0.0,"self_endowment_contribution":0.16479184330021646,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":2,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1512803,"name":"Nathan Constantine-Cooke","orcid":"0000-0002-4437-8713","position":1,"is_corresponding":false},{"id":1655980,"name":"Jake Kennedy","orcid":"0000-0003-3860-3977","position":2,"is_corresponding":false},{"id":1566136,"name":"Alexander Thomas Elford","orcid":"0000-0001-6144-1369","position":3,"is_corresponding":false},{"id":1655981,"name":"Claire O’Hare","orcid":null,"position":4,"is_corresponding":false},{"id":1655983,"name":"Colin Noble","orcid":null,"position":5,"is_corresponding":false},{"id":1512811,"name":"Gareth-Rhys Jones","orcid":null,"position":6,"is_corresponding":false},{"id":1655989,"name":"Ian D Arnott","orcid":null,"position":7,"is_corresponding":false},{"id":1566138,"name":"Charlie W Lees","orcid":null,"position":8,"is_corresponding":false},{"id":1512805,"name":"Nikolas Plevris","orcid":"0000-0002-3229-8759","position":9,"is_corresponding":false},{"id":1358511,"name":"Beatriz Gros","orcid":"0000-0002-5628-313X","position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Tofacitinib Versus Vedolizumab Among Bio-naive Patients With Ulcerative Colitis: A Real-World Propensity-Weighted Comparison","abstract":"<jats:title>Abstract</jats:title>\n               <jats:sec>\n                  <jats:title>Background and Aims</jats:title>\n                  <jats:p>Over the last decade, treatment options for moderate-to-severe ulcerative colitis (UC) have expanded. However, comparative studies between these agents are limited, especially among biologic-naive patients. We aimed to compare the persistence, effectiveness, and safety of tofacitinib and vedolizumab as the first advanced treatment for patients with UC.</jats:p>\n               </jats:sec>\n               <jats:sec>\n                  <jats:title>Methods</jats:title>\n                  <jats:p>Patients who received either tofacitinib or vedolizumab as their first advanced therapy for UC in NHS Lothian were included. We used inverse probability of treatment weighting. The probability of treatment assignment was calculated via logistic regression using age, sex, UC duration, Montreal extent, C-reactive protein, concomitant corticosteroids, and partial Mayo score at drug commencement.</jats:p>\n               </jats:sec>\n               <jats:sec>\n                  <jats:title>Results</jats:title>\n                  <jats:p>We included n = 158 patients, of whom n = 81 (51.3%) received vedolizumab and n = 77 (48.7%) tofacitinib. Median follow-up for vedolizumab patients was 3.1 years (interquartile range [IQR] 1.6-4.8) and for tofacitinib patients 1.5 years (IQR 0.3-2.3). The cohort was 59.5% male with a median age of 41.1 years (IQR 31.5-51.8). At 2 years, vedolizumab persistence was superior to tofacitinib (p = 0.005). At Weeks 12 and 52, clinical, biochemical, and fecal biomarker steroid-free remission were comparable between groups. Primary nonresponse and secondary loss of response were 9.9% and 17.3% for vedolizumab and 23.4% and 13% for tofacitinib, respectively. The frequency of adverse events was comparable (11 [13.6%] vedolizumab vs 19 [24.7%] tofacitinib, p = 0.629).</jats:p>\n               </jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions</jats:title>\n                  <jats:p>We found that the persistence and tolerability of vedolizumab were superior to tofacitinib in bio-naive UC, although the rates of clinical and biomarker remission were comparable. These data may help inform the positioning of advanced therapy.</jats:p>\n               </jats:sec>","is_dataset_classified":null,"base_score":1.0986122886681096,"endowment":1.0986122886681096,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"39659234","pmcid":"PMC12260496","openalex_id":"https://openalex.org/W4405296698","authors":[],"funders":[{"funder_name":"UKRI","grant_id":"MR/S034919/1","title":"Predicting disease flare and treatment response in inflammatory bowel disease"},{"funder_name":"Australian Commonwealth Government","grant_id":"","title":null},{"funder_name":"Clinical Research Career Development Fellowship","grant_id":"","title":null},{"funder_name":"Wellcome Trust","grant_id":"","title":null},{"funder_name":"Welcome Trust","grant_id":"","title":null},{"funder_name":"Clinical Research Career Development Fellowship","grant_id":"","title":null},{"funder_name":"Australian Commonwealth Government","grant_id":"","title":null}],"total_grants":7,"fwci":0.7761,"citation_percentile":0.76926855,"influential_citations":0,"citation_trend":[{"year":2025,"count":1},{"year":2026,"count":1}],"oa_status":"hybrid","license":"cc-by","oa_locations":[{"url":"https://academic.oup.com/ecco-jcc/advance-article-pdf/doi/10.1093/ecco-jcc/jjae188/61028582/jjae188.pdf","host_type":"journal"},{"url":"https://academic.oup.com/ecco-jcc/advance-article-pdf/doi/10.1093/ecco-jcc/jjae188/61028582/jjae188.pdf","host_type":"publisher"},{"url":"https://academic.oup.com/ecco-jcc/article-pdf/19/7/jjae188/61028582/jjae188.pdf","host_type":"publisher"},{"url":"https://doi.org/10.1093/ecco-jcc/jjae188","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/39659234","host_type":"repository"},{"url":"https://www.ncbi.nlm.nih.gov/pmc/articles/12260496","host_type":"repository"},{"url":"https://www.research.ed.ac.uk/files/528876188/jjae188.pdf","host_type":"repository"},{"url":"https://www.research.ed.ac.uk/en/publications/4ae48ef8-3448-4548-b41e-9a821100095f","host_type":"repository"},{"url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC12260496/pdf/jjae188.pdf","host_type":"repository"},{"url":"https://europepmc.org/articles/PMC12260496","host_type":"Europe_PMC"},{"url":"https://europepmc.org/articles/PMC12260496?pdf=render","host_type":"Europe_PMC"},{"url":"http://dx.doi.org/10.1093/ecco-jcc/jjae188","host_type":""},{"url":"https://www.pure.ed.ac.uk/ws/files/528876188/jjae188.pdf","host_type":""},{"url":"https://hdl.handle.net/20.500.11820/4ae48ef8-3448-4548-b41e-9a821100095f","host_type":""},{"url":"https://academic.oup.com/ecco-jcc/advance-article/doi/10.1093/ecco-jcc/jjae188/7920833","host_type":""}],"fields_of_study":["Inflammatory Bowel Disease","Rheumatoid Arthritis Research and Therapies","Microscopic Colitis","0301 basic medicine","03 medical and health sciences","0302 clinical medicine","Humans","Colitis, Ulcerative","Male","Female","Piperidines","Adult","Pyrimidines","Antibodies, Monoclonal, Humanized","Middle Aged","Gastrointestinal Agents","Propensity Score","Treatment Outcome"],"mesh_terms":["Adult","Colitis, Ulcerative","Female","Gastrointestinal Agents","Humans","Male","Middle Aged","Piperidines","Pyrimidines","Treatment Outcome","Propensity Score","Antibodies, Monoclonal, Humanized"],"keywords":["Vedolizumab","Medicine","Tofacitinib","Ulcerative colitis","Internal medicine","Gastroenterology","Disease","Biologics","Small Molecule","Real-world Data","Male","Adult","Middle Aged","Antibodies, Monoclonal, Humanized","Pyrimidines","Treatment Outcome","Piperidines","Gastrointestinal Agents","Humans","Original Article","Colitis, Ulcerative","Female","Propensity Score"],"sdg_mappings":[{"sdg_number":0,"sdg_label":"Good health and well-being"}],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-06T19:25:20.074884Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}