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Ustekinumab Has Better Cardiovascular Safety Than Vedolizumab in IBD Management
Older adults with IBD have higher cardiovascular risk; medication choice may affect cardiovascular outcomes. This study suggests ustekinumab users had fewer deaths and some cardiac events than vedolizumab users, which could influence treatment discussions for older patients on biologics.
Older adult IBD patients, clinicians who prescribe biologics, and researchers studying medication safety in IBD.
What To Know
What to know This article reports a conference study comparing cardiovascular safety outcomes for ustekinumab versus vedolizumab in adults aged 50+ with IBD.
The researchers used a large electronic health-record network (TriNetX), matched patients starting ustekinumab or vedolizumab, and found lower all-cause mortality, coronary revascularization, and NSTEMI rates in the ustekinumab group; differences for overall MACE, stroke, and acute MI were not significant. The authors conclude further research is needed.
Details and limitations The findings come from a propensity-matched observational analysis presented as an abstract at a meeting, not a randomized trial. Such studies can be affected by unmeasured confounding and differences in patients selected for each drug. The article cites event counts, follow-up time, and risk ratios reported by the abstract.
Practical note This report suggests cardiovascular safety may differ between these biologics in older adults, but it does not establish causation or recommend changing treatment. Patients should discuss individual risks and benefits with their clinician and consider that additional confirmatory studies are needed before drawing firm conclusions.
Results are from a propensity-matched cohort analysis presented at a conference (abstract); observational EHR studies can be confounded and do not replace randomized trials. The authors call for further research to confirm findings.
