S1613 Tofacitinib vs Vedolizumab for Ulcerative Colitis: A Systematic Review and Meta-Analysis of Real World Comparative Studies

Introduction: As the treatment options for ulcerative colitis (UC) patients grows, data on positioning therapies becomes critical. Both tofacitinib and vedolizumab are approved treatment options for moderate to severe UC, but head-to-head data remain limited. This study aims to compare the efficacy and safety of tofacitinib vs vedolizumab in the treatment of UC. Methods: MEDLINE, Embase, and the Cochrane Library were systematically searched. A random-effects model was used to calculate pooled odds ratios (ORs) with 95% confidence intervals (CIs). Heterogeneity was assessed using the I² statistic. Results: Six studies involving 1,858 patients were included. Only one study examined anti-TNF naïve patients. The 2 groups showed similar outcomes for steroid-free clinical remission (SFCR) at weeks 12–16 (OR, 1.11; 95% CI, 0.50–2.46; I² = 86%) and at week 52 (OR, 0.77; 95% CI, 0.56–1.13; I² = 88%), as well as for colectomy rates (OR, 1.63; 95% CI, 0.93–2.83; I² = 0) and adverse events (OR, 1.27; 95% CI, 0.98–1.64; I² = 0). Conclusion: In this meta-analysis of 6 studies involving 1,858 patients with UC, vedolizumab and tofacitinib showed similar efficacy and safety. Although not statistically significant, there was a trend toward lower colectomy rate and adverse event rates with vedolizumab compared with tofacitinib. Both drugs demonstrated comparable efficacy in achieving steroid-free clinical remission at both time points.