Research published in ‘Alimentary Pharmacology and Therapeutics’ revealed Ustekinumab to be more effective in achieving early and long‐term effectiveness as compared to vedolizumab in the treatment of Crohn's disease patients with failed response to anti‐TNF agents.

A total of 312 patients with Crohn's disease on vedolizumab and ustekinumab therapy were compared to to find the better out of the two in terms of overall effectiveness. They were exposed to at least 1 anti‐TNF agent. At week 54, corticosteroid‐free clinical remission described as Crohn's disease activity index <150 was regarded as the primary endpoint.

Out of the total, 224 patients used ustekinumab and 88 patients used vedolizumab therapy. The propensity score analysis found ustekinumab to be more effectively attained corticosteroid‐free clinical remission at week 54 and deep remission at week 14, as shown:

Table 1: Differences in corticosteroid‐free clinical remission and deep remission in both groups

Patients in the Ustekinumab had a lower rate of primary non-responders (6.7% versus 14.8%) and the long‐term drug withdrawal risk because of therapeutic failure. The predictors of ustekinumab failure were complicated phenotype and anti‐TNF primary non‐response.

Use of vedolizumab was no good in patients aged more than 35 years old, with non-complicated phenotype, no previous bowel resection, and no steroids at the starting.