Chenfei Zhang,1 Xiaoling Huang,1 Mailidan Maimaitiniyazi,1 Tingwei Zhou2 

1Xinjiang Uygur Autonomous Region People’s Hospital, Urumqi, Xinjiang, People’s Republic of China; 2Wenzhou Medical University, Wenzhou, Zhejiang, 325000, People’s Republic of China

Correspondence: Xiaoling Huang, Email Huangxiaolingzyf@sina.com

Objective: To compare the efficacy and safety of vedolizumab plus glucocorticoids versus infliximab in severe ulcerative colitis for optimized treatment selection.
Methods: Patients admitted to the Department of Gastroenterology of Xinjiang Uygur Autonomous Region People’s Hospital with confirmed diagnosis of ulcerative colitis from January 2020 to December 2022 were collected, and according to the biologics used, the patients were divided into Vedolizumab combined with glucocorticoids group (n = 23) and infliximab group (n = 23). Clinically relevant indicators of the patients were retrospectively analyzed.
Results: The difference between the basic information of the two groups of patients before treatment was not significant (p > 0.05). WBC 30 weeks, ESR (6 weeks, 30 weeks), ALB 30 weeks, Hb (6 weeks, 14 weeks, 30 weeks) of the difference between the groups was statistically significant (p < 0.05). WBC, CRP, ESR, ALB, Hb were tested by ANOVA, the differences between groups were statistically significant (p < 0.05). Comparison of the incidence of various complications between the two groups of patients, the difference was not significant (p > 0.05). The clinical response rate, clinical remission rate and mucosal healing rate of the 2 groups were statistically analyzed in terms of treatment effects at weeks 6, 14 and 30, respectively. Comparison between the groups showed that the differences in clinical response rate at week 6, clinical remission rate and endoscopic remission rate at week 30 and at weeks 14 and 30 were not statistically significant (p > 0.05); at weeks 14 and 30, the clinical response rate of group A was better than that of group B, and the differences were statistically significant (p < 0.05). At week 14, the clinical remission rate of group A was better than that of group B, and the difference was statistically significant (p < 0.05).
Conclusion: Vedolizumab and infliximab are effective for severe UC, but vedolizumab with glucocorticoids outperforms infliximab in clinical response, remission, and long-term outcomes.

Keywords: ulcerative colitis, vedolizumab, glucocorticoid, infliximab, efficacy