Should we use anti-tumor necrosis factor agents or vedolizumab as first-line biological therapy in ulcerative colitis?

Publication date: Available online 12 May 2018Source: Best Practice & Research Clinical GastroenterologyAuthor(s): Lieven Pouillon, Johan Van Stappen, Peter Bossuyt, Silvio Danese, Laurent Peyrin-BirouletAbstractRandomized controlled trials with direct comparisons between the different available biological agents in ulcerative colitis are lacking. The comparative efficacy, safety and tolerability, patient profile, patient preference and costs should be taken into account when choosing an appropriate first-line biological. Tumor necrosis factor antagonists have a systemic mode of action, while vedolizumab is mainly gut-selective, and this influences the clinical profile of both treatment options. Tofacitinib will further expand the therapeutic armamentarium in ulcerative colitis. Results of ongoing head-to-head trials between biological agents are likely to change clinical practice in the near future. Biomarkers that predict response to different treatment options in an individual patient are warranted.
Source: Best Practice and Research Clinical Gastroenterology - Category: Gastroenterology Source Type: research