The Impact of Vedolizumab and Ustekinumab on Articular Extra-Intestinal Manifestations in Inflammatory Bowel Disease Patients: A Real-Life Multicentre Cohort Study

Cara De Galan, Marie Truyens, Harald Peeters, Francisco Mesonero Gismero, Ainara Elorza, Paola Torres, Liv Vandermeulen, Aranzazu Jauregui Amezaga, Rocio Ferreiro-Iglesias, Tom Holvoet, Yamile Zabana, Laia Peries Reverter, Gerard Bryan Gonzales, Jeroen Geldof, Gaëlle Varkas, Martine De Vos, Triana Lobatón

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Abstract

BACKGROUND AND AIMS: Extra-intestinal manifestations are frequently reported in inflammatory bowel diseases. However, data comparing the effect of vedolizumab and ustekinumab on articular extra-intestinal manifestations are limited. The aim here was to evaluate differences in new-onset and the evolution of pre-existing joint extra-intestinal manifestations during both treatments.

METHODS: An international multicentre retrospective study was performed on inflammatory bowel disease patients who started vedolizumab or ustekinumab between May 2010 and December 2020. Extra-intestinal manifestations were assessed at baseline and joint extra-intestinal manifestations were evaluated throughout the 2-year follow-up. Arthropathy was defined by joint inflammation [arthritis/sacroiliitis], diagnosed by a rheumatologist, and arthralgia as articular pain without confirmed inflammation. Additionally, skin, ocular and hepatic extra-intestinal manifestations were assessed at baseline. Uni- and multivariate analyses were performed.

RESULTS: In total, 911 patients [vedolizumab: 584; ustekinumab: 327] were included. Deterioration of pre-existing arthropathy and rate of new-onset arthropathy were not significantly associated with vedolizumab over ustekinumab. Arthropathy was used as reason to stop treatment in six vedolizumab and two ustekinumab patients. The odds of developing new arthralgia within 6 months was higher in patients who took vedolizumab compared to ustekinumab (adjusted odds ratio [aOR]: 2.28 [1.01-5.15], p = 0.047). However, this effect was not sustained during the 2-year follow-up (aOR: 1.35 [0.80-2.29], p = 0.259). Deterioration of pre-existing arthralgia was comparable between ustekinumab and vedolizumab-treated patients. In two vedolizumab-treated patients arthralgia was given as the reason to stop treatment.

CONCLUSIONS: Vedolizumab and ustekinumab can be used safely in patients with articular extra-intestinal manifestations. Only a temporary increased risk for developing arthralgia has been observed under vedolizumab.

Original languageEnglish
Pages (from-to)1676-1686
Number of pages11
JournalJournal of Crohn's & Colitis
Volume16
Issue number11
DOIs
Publication statusPublished - 23 Nov 2022

Bibliographical note

Publisher Copyright:
© 2022 The Author(s). Published by Oxford University Press on behalf of European Crohn's and Colitis Organisation. All rights reserved.

Copyright:
Copyright 2023 Elsevier B.V., All rights reserved.

Keywords

  • Humans
  • Ustekinumab/adverse effects
  • Retrospective Studies
  • Inflammatory Bowel Diseases/complications
  • Cohort Studies
  • Arthritis/complications
  • Inflammation/complications
  • Arthralgia/chemically induced

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