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Comparative Study of the Effectiveness of Vedolizumab Versus Ustekinumab After Anti-TNF Failure in Crohn's Disease (Versus-CD): Data from the ENEIDA Registry.

Publicated to:Journal Of Crohns & Colitis. 18 (1): 65-74 - 2024-01-27 18(1), DOI: 10.1093/ecco-jcc/jjad124

Authors: García MJ; Rivero M; Fernández-Clotet A; de Francisco R; Sicilia B; Mesonero F; de Castro ML; Casanova MJ; Bertoletti F; García-Alonso FJ; López-García A; Vicente R; Calvet X; Barreiro-de Acosta M; Ferrer Rosique J; Varela Trastoy P; Nuñez A; Ricart E; Riestra S; Arias García L; Rodríguez M; Arranz L; Pajares R; Mena R; Calafat M; Camo P; Bermejo F; Ponferrada Á; Madrigal RE; Llaó J; Sesé E; Sánchez E; Pineda Mariño JR; González Muñoza C; Carbajo López AY; Julián AB; Villoria Ferrer A; Baston-Rey I; Jara L; Almela P; Codesido L; de la Maza S; Leal C; Caballol B; Pérez-Martínez I; Vinuesa Campo R; Crespo J; Domènech E; Chaparro M; Gisbert JP

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Abstract

Both vedolizumab and ustekinumab are approved for the management of Crohn's disease [CD]. Data on which one would be the most beneficial option when anti-tumour necrosis factor [anti-TNF] agents fail are limited. To compare the durability, effectiveness, and safety of vedolizumab and ustekinumab after anti-TNF failure or intolerance in CD. CD patients from the ENEIDA registry who received vedolizumab or ustekinumab after anti-TNF failure or intolerance were included. Durability and effectiveness were evaluated in both the short and the long term. Effectiveness was defined according to the Harvey-Bradshaw index [HBI]. The safety profile was compared between the two treatments. The propensity score was calculated by the inverse probability weighting method to balance confounder factors. A total of 835 patients from 30 centres were included, 207 treated with vedolizumab and 628 with ustekinumab. Dose intensification was performed in 295 patients. Vedolizumab [vs ustekinumab] was associated with a higher risk of treatment discontinuation (hazard ratio [HR] 2.55, 95% confidence interval [CI]: 2.02-3.21), adjusted by corticosteroids at baseline [HR 1.27; 95% CI: 1.00-1.62], moderate-severe activity in HBI [HR 1.79; 95% CI: 1.20-2.48], and high levels of C-reactive protein at baseline [HR 1.06; 95% CI: 1.02-1.10]. The inverse probability weighting method confirmed these results. Clinical response, remission, and corticosteroid-free clinical remission were higher with ustekinumab than with vedolizumab. Both drugs had a low risk of adverse events with no differences between them. In CD patients who have failed anti-TNF agents, ustekinumab seems to be superior to vedolizumab in terms of durability and effectiveness in clinical practice. The safety profile is good and similar for both treatments.

Keywords

Antibodies, monoclonal, humanizedCrohn diseaseCrohn’s diseaseDurabilityEffectivenessHumansRegistriesRemission inductionRetrospective studiesTreatment outcomeTumor necrosis factor inhibitorsTumor necrosis factor-alphaUstekinumabVedolizumab

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal Journal Of Crohns & Colitis due to its progression and the good impact it has achieved in recent years, according to the agency WoS (JCR), it has become a reference in its field. In the year of publication of the work, 2024 there are still no calculated indicators, but in 2023, it was in position 14/143, thus managing to position itself as a Q1 (Primer Cuartil), in the category Gastroenterology & Hepatology. Notably, the journal is positioned above the 90th percentile.

From a relative perspective, and based on the normalized impact indicator calculated from the Field Citation Ratio (FCR) of the Dimensions source, it yields a value of: 10.31, which indicates that, compared to works in the same discipline and in the same year of publication, it ranks as a work cited above average. (source consulted: Dimensions May 2025)

Specifically, and according to different indexing agencies, this work has accumulated citations as of 2025-05-28, the following number of citations:

  • Scopus: 9
  • Europe PMC: 5
  • OpenCitations: 7

Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2025-05-28:

  • The use, from an academic perspective evidenced by the Altmetric agency indicator referring to aggregations made by the personal bibliographic manager Mendeley, gives us a total of: 44.
  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 44 (PlumX).

With a more dissemination-oriented intent and targeting more general audiences, we can observe other more global scores such as:

  • The Total Score from Altmetric: 60.1.
  • The number of mentions on the social network X (formerly Twitter): 88 (Altmetric).