Inflamm Bowel Dis
Newer biologics for IBD: How do they compare in terms of serious infection risk?
Study details: This retrospective cohort study analyzed 14,554 adults with inflammatory bowel disease (IBD) treated within the VA system between 2014 and 2023. Patients were newly initiated on one of five medication categories: anti-TNF monotherapy, anti-TNF + thiopurine (TP) combination, vedolizumab, ustekinumab, or tofacitinib. Primary outcome: hospitalization for serious infection, assessed using time-updated medication exposure and adjusted survival analysis.
Results: Over a median follow-up of 49.5 months, 3,131 serious infection hospitalizations occurred. No medication class showed a statistically significant increase in overall infection-related hospitalization risk compared with anti-TNF + TP therapy. However, vedolizumab was associated with a higher risk of GI infections (hazard ratio, 1.42; 95% confidence interval, 1.13–1.80; P=.003). Anti-TNF monotherapy had the lowest crude infection rate.
Clinical impact: These findings suggest that vedolizumab, ustekinumab, and tofacitinib don’t confer increased overall infection-related hospitalization risk compared with combination anti-TNF + TP therapy. Clinicians can prioritize efficacy when selecting IBD treatments, with infection risk playing a secondary role in decision-making.
Source:
Khan N, et al. (2025, October 16). Inflamm Bowel Dis. Comparative Risk of Serious Infections Associated With Treatment of Inflammatory Bowel Disease. https://pubmed.ncbi.nlm.nih.gov/41101763/