Summary

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• This summary is based on the review of 30 systematic review(s)/meta-analysis(es). ^[1-30]
• Vedolizumab was effective in inducing and maintaining clinical remission and response in patients with both ulcerative colitis (UC) and Crohn’s disease (CD), with higher remission rates during both induction (relative risk (RR) = 2.09) and maintenance (RR = 1.98) phases compared to placebo.
• Comparative data showed infliximab was more effective than vedolizumab in the induction phase for CD, with similar maintenance efficacy. For UC, infliximab demonstrated higher induction efficacy, while adalimumab was ranked highest for corticosteroid-free remission in the maintenance phase.
• Vedolizumab was particularly beneficial for patients with prior tumor necrosis factor (TNF) antagonist failure, enhancing clinical remission and response, and was notably effective in maintaining remission in UC. Additionally, vedolizumab demonstrated efficacy in biologic-naive patients, showing comparable outcomes to tofacitinib, especially in those with prior TNF antagonist exposure.
• Vedolizumab generally exhibited a favorable safety profile, with overall adverse events (AEs) and serious adverse events (SAEs) similar to placebo; no significant increase in Clostridium difficile infection risk was noted in UC patients.
• Specific adverse events associated with vedolizumab included cases of acute interstitial nephritis (AIN), which were rare but potentially serious, and nasopharyngitis in CD patients.
• Comparative safety findings indicated that infliximab had a higher infection rate in CD compared to vedolizumab, while adalimumab had a greater risk of infection during induction. Ustekinumab showed fewer infections and SAEs, making it the top-ranked drug for safety during both induction and maintenance phases.
• Vedolizumab demonstrated effectiveness in moderate-to-severe IBD, UC, and CD, particularly in patients with prior TNF antagonist failure, where it improved clinical remission and response; pediatric studies also suggested potential for achieving remission, though data quality was low. Specific subgroup findings included a majority female prevalence in AIN cases and fistula healing in approximately one-third of perianal fistulizing CD patients treated with vedolizumab, especially those with prior TNF therapy failure.