{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T21:21:01Z","timestamp":1792099261830,"version":"4.4.0"},"reference-count":39,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T00:00:00Z","timestamp":1752537600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>\u2018Gut\u2010specific\u2019 biologics are associated with fewer infectious complications than \u2018systemic\u2019 biologics in inflammatory bowel disease (IBD) which represents an important consideration in transplant recipients. This study evaluated the safety of combining transplant immunosuppression with \u2018gut\u2010specific\u2019 versus \u2018systemic\u2019 biologics to manage IBD following liver transplantation (LTx).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective dual\u2010centre study of IBD patients exposed to biologics following LTx between 2001 and 2023 was undertaken. Primary outcome was the incidence rate of infectious events per patient\u2010year of biologic exposure. Infectious events were stratified by \u2018gut\u2010specific\u2019 (vedolizumab) and \u2018systemic\u2019 (anti\u2010TNF\/ustekinumab) biologic exposure with severe events defined by hospitalisation. Secondary outcomes included the impact of non\u2010biologic immunosuppression on the incidence of infectious and non\u2010infectious complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirty\u2010six IBD patients were exposed to 59 (median 12 [IQR 6\u201327] months) biologic episodes following LTx. Patients were collectively exposed to 44.5 and 44.4 patient\u2010years of \u2018gut\u2010specific\u2019 (vedolizumab\u2009=\u200927 [45.7%]) and \u2018systemic\u2019 (anti\u2010TNF\u2009=\u200922 [37.2%]; ustekinumab\u2009=\u200910 [16.9%]) biologics, respectively. Twenty\u2010seven (45.7%) biologic episodes were associated with 41 infectious events, a median of 8\u2009months (IQR 4.5\u201313.5) following biologic initiation. Rates of infectious events were not significantly different between \u2018gut\u2010specific\u2019 and \u2018systemic\u2019 biologic exposures (0.43 vs. 0.50 per patient\u2010year, incidence rate ratio [IRR] 1.09 [95% CI 0.58\u20132.02,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.79]). Corticosteroid exposure at biologic initiation was the only non\u2010biologic immunosuppressant associated with severe infectious events (IRR 5.40 [95% CI 1.66\u201317.63,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01]).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Incidence of infectious events observed between IBD\/LTx patients exposed to \u2018gut\u2010specific\u2019 and \u2018systemic\u2019 biologics were similar. Biologic choice should not be influenced by concerns regarding their co\u2010prescription with transplant immunosuppression. Corticosteroid co\u2010therapy at biologic initiation may be associated with more severe infectious events.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/apt.70283","type":"journal-article","created":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T14:43:35Z","timestamp":1752590615000},"page":"1003-1011","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Systemic Biologics Have Similar Safety to Vedolizumab in Inflammatory Bowel Disease Patients Following Liver Transplantation"],"prefix":"10.1111","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3656-3097","authenticated-orcid":false,"given":"Simone","family":"Chin","sequence":"first","affiliation":[{"name":"Department of Gastroenterology Royal Prince Alfred Hospital  Sydney Australia"},{"name":"Department of Gastroenterology Austin Health  Melbourne 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Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0453-3168","authenticated-orcid":false,"given":"Ken","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Royal Prince Alfred Hospital  Sydney Australia"},{"name":"University of Sydney  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Testro","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Austin Health  Melbourne Australia"},{"name":"The Australian Centre for Transplantation Excellence and Research, Austin Health  Melbourne Australia"},{"name":"The Department of Surgery (Austin Precinct) The University of Melbourne  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3399-7236","authenticated-orcid":false,"given":"Peter","family":"De Cruz","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Austin Health  Melbourne Australia"},{"name":"Department of Medicine, Austin Health The University of Melbourne  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5206-0097","authenticated-orcid":false,"given":"Matthew C.","family":"Choy","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Austin Health  Melbourne Australia"},{"name":"Department of Medicine, Austin Health The University of Melbourne  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashish","family":"Srinivasan","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Austin Health  Melbourne Australia"},{"name":"Department of Medicine, Austin Health The University of Melbourne  Melbourne Australia"},{"name":"Eastern Health Clinical School Monash University  Clayton 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