🫀 Comparative safety of advanced therapies in Crohn's disease: no signal for increased VTE
🔥 Main in 3 points
- No significant differences in risk of serious infections, VTE, or MACE across TNF antagonists, vedolizumab, ustekinumab, risankizumab, and upadacitinib in CD.
- VTE rates were low (0.90–2.33 per 100 person-years; no agent had a statistically higher risk).
- Supports deciding between advanced therapies based on efficacy, not differential safety signals.
🧪 Context
Retrospective comparative effectiveness study (n=12,245; OptumLabs claims, US; 2016–2024) using multinomial propensity scoring; compared risk across 5 biologics/JAK inhibitors for patients with CD.
📍 Practical significance
When treating Crohn’s disease with advanced therapies—including vedolizumab—concerns about VTE or major CV events should not drive therapy choice. Select agents primarily on comparative clinical efficacy and patient factors.
🔗 Source — PubMed | doi.org/10.1001/jamanetworkopen.2025.57922
🧩 Predicting vedolizumab response in UC: machine learning models emerging
🔥 Main in 3 points
- Vedolizumab remains a key agent for moderate-to-severe ulcerative colitis; RCTs confirm efficacy.
- 20–40% of patients may show primary non-response—need for precision strategies.
- Machine learning models (AUC up to 0.82) are showing promise in predicting response.
🧪 Context
Synthesis of major RCTs & meta-analyses (GEMINI 1, VARSITY) and AI predictive modelling literature.
📍 Practical significance
Using AI-driven prediction (e.g., neural networks using clinical, lab and tissue data) may help identify UC patients more likely to respond to vedolizumab, reduce ineffective cycling, and optimise precision selection.
🔗 Source — PubMed | doi.org/10.1371/journal.pdig.0001208
❓ Can immunophenotyping help guide vedolizumab selection in UC?
✅ Study answer
Prospective phase 4 study (n=11): Patients with a higher baseline proportion of CD161+ memory CD4+ T cells in inflamed colorectal tissue had greater likelihood of long-term remission at week 54 with vedolizumab (48.5% vs 31.3%; p=0.0303).
📍 How to apply
Consider that T cell immunophenotype assessment in tissue may become a tool to stratify patients for vedolizumab therapy, improving remission rates and personalisation. Still investigational, but increasingly supported by mechanistic and translational evidence.
🔗 Source — PubMed | doi.org/10.1371/journal.pone.0340271
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