{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:06:03Z","timestamp":1790813163014,"version":"4.1.0"},"reference-count":25,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82341223"],"award-info":[{"award-number":["82341223"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background &amp; Aims<\/jats:title>\n                    <jats:p>Head-to-head comparative evidence between upadacitinib and vedolizumab for anti-tumor necrosis factor (TNF)-exposed ulcerative colitis (UC) patients is lacking. This study compared their real-world effectiveness and safety.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This multicenter retrospective cohort included anti-TNF-exposed UC patients with a partial adapted Mayo score \u2265 2 who received upadacitinib or vedolizumab between March 2021 and February 2026 and had a minimum of 16\u2009weeks of follow-up. Clinical outcomes were assessed at weeks 16 and 26, with endoscopic evaluation at week 26. The primary outcome was steroid-free symptomatic remission (SFSR) at week 16, defined as rectal bleeding subscore = 0 and stool frequency subscore \u2264 1, with no corticosteroid use for at least 2\u2009weeks prior to assessment. Propensity score-based inverse probability of treatment weighting (IPTW) was used to adjust for imbalance of baseline characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 242 patients were analyzed (120 vedolizumab, 122 upadacitinib). After IPTW, upadacitinib was superior in achieving week-16 SFSR (71.7% vs 54.6%; adjusted odds ratio [aOR] 2.11, 95% CI, 1.67-2.65, P &amp;lt; .001). At week 26, upadacitinib remained superior in SFSR (82.6% vs 61.8%; aOR 2.93, 95% CI, 1.85-4.66, P &amp;lt; .001) and also demonstrated higher rates of endoscopic improvement (75.3% vs 47.1%; aOR 3.42, 95% CI, 2.57-4.56, P &amp;lt; .001), and endoscopic remission (41.5% vs 22.2%; aOR 2.49, 95% CI, 1.71-3.63, P &amp;lt; .001). There was no significant difference regarding the risk of drug discontinuation between the two groups (aHR 0.46, 95% CI, 0.20-1.04, P\u2009=\u2009.058). However, the overall incidence of adverse events was higher with upadacitinib (0.475 vs 0.213 per person-year, P &amp;lt; .001), while the rates of serious adverse events were not significantly different between groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Upadacitinib demonstrates superior effectiveness over vedolizumab in anti-TNF-exposed UC but carries a higher burden of adverse events, highlighting the need for personalized benefit-risk assessment to guide treatment selection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ibd\/izag179","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T11:41:04Z","timestamp":1790682064000},"source":"Crossref","is-referenced-by-count":0,"title":["Comparative effectiveness and safety of upadacitinib versus vedolizumab in anti-TNF-exposed patients with ulcerative colitis"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9941-0576","authenticated-orcid":false,"given":"Jian","family":"Wan","sequence":"first","affiliation":[{"name":"State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers and National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University , Xi\u2019an,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Zhang","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers and National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University , Xi\u2019an,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaojie","family":"Yuan","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Public Health, Fourth Military Medical University , Xi\u2019an,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhengyu","family":"Ren","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, The First Affiliated Hospital of Xi\u2019an Jiaotong University , Xi\u2019an,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sumei","family":"Sha","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, The Second Affiliated Hospital of Xi\u2019an Jiaotong University , Xi\u2019an,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Changyue","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Tangdu Hospital, Fourth Military Medical University , Xi\u2019an,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingchao","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, The First Affiliated Hospital of Xi\u2019an Jiaotong University , Xi\u2019an,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, The Second Affiliated Hospital of Xi\u2019an Jiaotong University , Xi\u2019an,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Tangdu Hospital, Fourth Military Medical University , Xi\u2019an,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaming","family":"Zhou","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers and National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University , Xi\u2019an,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuhan","family":"Hu","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers and National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University , Xi\u2019an,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fei","family":"Chen","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers and National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University , Xi\u2019an,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3004-2634","authenticated-orcid":false,"given":"Min","family":"Chen","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers and National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University , Xi\u2019an,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Liang","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers and National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University , 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