P1174 - Tofacitinib vs Vedolizumab for Ulcerative Colitis: A Systematic Review and Meta-Analysis of Real World Comparative Studies

Lucas M. Delgado, MS¹, Jilpa Shah, DO², Sudiksha Veerareddy, MD², Gregory Brennan, MD³
1Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil; 2Medical City Healthcare, Arlington, TX; 3GI Alliance, Mansfield, TX

Introduction: As the treatment options for ulcerative colitis (UC) patients grows, data on positioning therapies becomes critical. Both tofacitinib and vedolizumab are approved treatment options for moderate to severe UC, but head-to-head data remain limited. This study aims to compare the efficacy and safety of tofacitinib vs vedolizumab in the treatment of UC.

Methods: MEDLINE, Embase, and the Cochrane Library were systematically searched. A random-effects model was used to calculate pooled odds ratios (ORs) with 95% confidence intervals (CIs). Heterogeneity was assessed using the I² statistic.

Results: Six studies involving 1,858 patients were included (see TABLE 1). Only one study examined anti-TNF naïve patients. The two groups showed similar outcomes for steroid-free clinical remission (SFCR) at weeks 12–16 (OR, 1.11; 95% CI, 0.50–2.46; I² = 86%) and at week 52 (OR, 0.77; 95% CI, 0.56–1.13; I² = 88%), as well as for colectomy rates (OR, 1.63; 95% CI, 0.93–2.83; I² = 0) and adverse events (OR, 1.27; 95% CI, 0.98–1.64; I² = 0) (see FIGURE 1).

Discussion: In this meta-analysis of six studies involving 1,858 patients with UC, vedolizumab and tofacitinib showed similar efficacy and safety. Although not statistically significant, there was a trend toward lower colectomy rate and adverse event rates with vedolizumab compared with tofacitinib. Both drugs demonstrated comparable efficacy in achieving steroid-free clinical remission at both time points.


Figure: FIGURE 1. Forrest plots showing colectomy and adverse event rates.


Figure: TABLE 1. Characteristics of included studies.

Disclosures:
Lucas Delgado indicated no relevant financial relationships.
Jilpa Shah indicated no relevant financial relationships.
Sudiksha Veerareddy indicated no relevant financial relationships.
Gregory Brennan indicated no relevant financial relationships.

Lucas M. Delgado, MS¹, Jilpa Shah, DO², Sudiksha Veerareddy, MD², Gregory Brennan, MD³. P1174 - Tofacitinib vs Vedolizumab for Ulcerative Colitis: A Systematic Review and Meta-Analysis of Real World Comparative Studies, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.