Introduction:

Crohn’s Disease (CD), while primarily affecting the gastrointestinal tract, has been known to present extra-intestinal manifestations and has historically required surgical intervention in severe cases. The emergence of biologic therapies has reshaped its management, though some treatment-resistant patients may still undergo colectomy. Evidence comparing the effectiveness of biologics such as ustekinumab and vedolizumab in maintaining remission post-colectomy has remained limited. To address this gap, the comparative effectiveness of these agents was evaluated using real-world data.

Methods:

A retrospective cohort analysis was carried out using the TriNetX database. Patients with moderate to severe CD who had undergone colectomy were identified. Two cohorts—those treated with ustekinumab and those with vedolizumab—were compared for clinical remission at 26 and 52 weeks post-colectomy. Propensity score matching (1:1) was applied based on age, sex, and disease onset. Outcomes were assessed using chi-square tests and Cox proportional hazards models. Statistical significance was set at p < 0.05.

Results: A total of 374 post-colectomy CD patients were analyzed.

Following propensity score matching, vedolizumab was associated with a significantly greater rate of clinical remission at 52 weeks compared to ustekinumab.

Conclusion:

In patients with Crohn’s Disease who had undergone colectomy, vedolizumab demonstrated superior efficacy over ustekinumab in maintaining clinical remission at 52 weeks. These findings suggest that vedolizumab may be a more effective long-term treatment option in this subgroup. However, randomized controlled trials are warranted to further validate these results.

Digestive Disease Week 2025, May 3rd – 6th, San Diego