One-year single-center follow-up study of ustekinumab and vedolizumab use in inflammatory bowel disease Egyptian patients as second-line therapy after anti-TNF failure

Introduction
Inflammatory bowel disease (IBD) is mainly treated medically, especially with the availability of biological agents. Although anti-TNF drugs have been the only biological drugs available to treat ulcerative colitis (UC) and Crohn’s disease (CD) patients for too many years, recently novel biological therapies have been approved for therapy. Using these novel agents as second-line biological therapies has proven to have a good effect on the induction and maintenance of remission of these diseases.

Aim
To evaluate the effectiveness of second-line biologics (ustekinumab and vedolizumab) after an anti-TNF agent failure.

Material and methods
From 50 IBD patients receiving biological therapy, 26 patients with severe UC and CD receiving vedolizumab and ustekinumab for 1 year were chosen for this observational and cross-sectional study.

Results
80% of CD patients received vedolizumab, while 75% of UC patients received ustekinumab. UC activity as indicated by the Mayo Scoring Index significantly decreased during follow-up, while CD activity as indicated by Crohn’s Disease Activity Index (CDAI) did not significantly decrease with the rise of inflammatory markers, which could be due to the small number of IBD patients who received vedolizumab and ustekinumab.

Conclusions
There was superior effectiveness of ustekinumab compared to vedolizumab in treating UC patients with prior anti-TNF treatment failure.