Comparative efficacy and safety of infliximab and vedolizumab therapy in patients with inflammatory bowel disease: a systematic review and meta-analysis

BMC Gastroenterol. 2022 Jun 8;22(1):291.doi: 10.1186/s12876-022-02347-1.


Laurent Peyrin-Biroulet 1Perttu Arkkila 2Alessandro Armuzzi 3Silvio Danese 4Jordi Guardiola 5Jørgen Jahnsen 6Charles Lees 7Edouard Louis 8Milan Lukáš 9Walter Reinisch 10Xavier Roblin 11Minyoung Jang 12Han Geul Byun 12Dong-Hyeon Kim 12Sung Jeong Lee 12Raja Atreya 13


Author information

1Centre Hospitalier Régional Universitaire de Nancy, Nancy, France.

2Department of Gastroenterology, Helsinki University and Helsinki University Hospital, Helsinki, Finland.

3Humanitas Research Hospital, Milan, Rozzano, Italy.

4Gastroenterology and Endoscopy, University Vita-Salute San Raffaele, Milan, Italy.

5Digestive Diseases Department, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain.

6Department of Gastroenterology, Institute of Clinical Medicine, Akershus University Hospital, University of Oslo, Oslo, Norway.

7Center of Genomics and Experimental Medicine, University of Edinburgh, Edinburgh, UK.

8Department of Gastroenterology, University Hospital CHU of Liège, Liège, Belgium.

9ISCARE Clinical Centre, Prague, Czech Republic.

10Medical University of Vienna, Vienna, Austria.

11University Hospital of Saint-Etienne, Saint-Etienne, France.

12Celltrion Healthcare, Incheon, Republic of Korea.

13Medical Department 1, University Hospital Erlangen, Friedrich-Alexander-University of Erlangen-Nürnberg, Ulmenweg 18, 91054, Erlangen, Germany. raja.atreya@uk-erlangen.de.


Background and aims: There are limited comparative data for infliximab and vedolizumab in inflammatory bowel disease patients.

Methods: We conducted a systematic review and meta-analysis to compare the efficacy and safety of infliximab and vedolizumab in adult patients with moderate-to-severe Crohn's disease or ulcerative colitis.

Results: We identified six eligible Crohn's disease and seven eligible ulcerative colitis trials that randomised over 1900 participants per disease cohort to infliximab or vedolizumab. In the Crohn's disease and ulcerative colitis cohorts, infliximab yielded better efficacy than vedolizumab for all analysed outcomes (CDAI-70, CDAI-100 responses, and clinical remission for Crohn's disease and clinical response and clinical remission for ulcerative colitis) during the induction phase, with non-overlapping 95% confidence intervals. In the maintenance phase, similar proportions of infliximab- or vedolizumab-treated patients achieved clinical response, clinical remission, or mucosal healing in both Crohn's disease and ulcerative colitis. For the safety outcomes, rates of adverse events, serious adverse events, and discontinuations due to adverse events were similar in infliximab- and vedolizumab-treated patients in both diseases. The infection rate was higher in infliximab for Crohn's disease and higher in vedolizumab when treating patients with ulcerative colitis. There was no difference between the treatments in the proportions of patients who reported serious infections in both indications.

Conclusions: Indirect comparison of infliximab and vedolizumab trials in adult patients with moderate-to severe Crohn's disease or ulcerative colitis demonstrated that infliximab has better efficacy in the induction phase and comparable efficacy during the maintenance phase and overall safety profile compared to vedolizumab.



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