ArticleClinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association2024
Comparative Effectiveness of Biologic Therapies in Preventing Penetrating Complications in Patients With Crohn's Disease.
Article in Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 12 citations in OpenAlex.
- STRIDE-II treatment target achievement in inflammatory bowel disease: a cross-sectional study from a tertiary IBD centre in the United Arab Emirates.Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association · 2026Article
- Extensive trans-organ urogenital fistulation in Crohn's disease involving the bowel, urinary bladder, seminal vesicles, and prostate: Radiological perspective of a case.Radiology case reports · 2026Article
- Cross-Sectional Imaging Features Associated With Disease Progression in Crohn's Disease.Inflammatory bowel diseases · 2026Article
- Spatial fibroblast niches define Crohn's fistulae.Nature · 2026Article
- Hyperbaric Oxygen Therapy in the Management of Refractory Perianal Crohn's Disease.Journal of clinical medicine · 2025Article
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Authors and funding
4 authors at 2 institutions in 2 countries.
Funding
Abstract
BACKGROUND &
aimsComparative effectiveness of biologics in preventing penetrating disease (PD) in Crohn's disease (CD) is not well established. We compared the risk of developing luminal and perianal PD (LPD and PPD) between biologics used as first-line therapies.
methodsAdults (>17 years) with CD who initiated their first biologic (anti-tumor necrosis factor [anti-TNF], ustekinumab [UST], or vedolizumab [VDZ]) were identified from Merative Commercial Database (2006 and 2020). We excluded preexisting PD using a minimum look-back period of 1 year. Cohorts were balanced by inverse probability of treatment weighting based on age, sex, comorbidities, prior CD surgery, and CD severity. Pairwise comparisons were performed by Cox proportional hazards models, adjusted for immunomodulator exposure, and with biologic exposure treated as a time-dependent variable based on a medication possession ratio of 0.8.
resultsOur analysis included 40,693 patients: 93% anti-TNF, 3% UST, and 4% VDZ. After inverse probability of treatment weighting all comparisons were well balanced. Anti-TNF was protective against LPD (hazard ratio, 0.66; 95% confidence interval, 0.55-0.78; P < .0001) and PPD (hazard ratio, 0.88; 95% confidence interval, 0.80-0.96; P = .0045) compared with VDZ and LPD (hazard ratio, 0.37; 95% confidence interval, 0.30-0.46; P < .0001) compared with UST. There were no significant differences in the risk of LPD and PPD between VDZ and UST. These results were similar after limiting the study period to after 2016.
conclusionsAnti-TNF therapy was associated with a lower risk of LPD and PPD compared with VDZ, and lower risk of LPD compared with UST. Further studies are needed to validate these findings and to determine potential reasons for these differences.
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