Extraintestinal Manifestations in Vedolizumab and Anti-TNF-Treated Patients With Inflammatory Bowel Disease.

摘要: Background Extra-intestinal manifestations (EIMs) can impact morbidity in patients with inflammatory bowel diseases (IBD; Crohn's disease [CD] and ulcerative colitis [UC]). This study compared incidence rates of EIMs moderate to severe IBD receiving gut-selective vedolizumab (VDZ) vs those systemic anti-tumor necrosis factor (anti-TNF) therapies. Methods Adult VDZ or anti-TNFs were identified from the MarketScan claims database September 28, 2012, through 30, 2016. Incidence between 2 cohorts. Descriptive analyses performed for all courses treatment. Generalized linear models estimated treatment on likelihood developing EIMs. Results Compared anti-TNF therapy, VDZ-treated CD 28% more likely develop "any EIMs" (adjusted incident rate ratio [IRR], 1.28; 95% confidence interval [CI], 1.02-1.62). Specifically, treated erythema nodosum (IRR, 4.29; CI, 1.73-10.64), aphthous stomatitis 3.73; 1.51-9.23), episcleritis/scleritis 2.51; 1.02-6.14), arthropathy 1.45; 1.15-1.84), primary sclerosing cholangitis (PSC) 7.79; 3.32-18.27), uveitis/iritis 2.89; 1.35-6.18). UC did not have a statistically significant increase anti-TNFs, but specific (aphthous stomatitis: IRR, 3.67; 1.30-10.34; pyoderma gangrenosum: 4.42; 1.00-19.45; PSC: 3.44; 1.23-9.68). Conclusions may be The control potentially limit its clinical effect EIM prevention.