The Risk of Tuberculosis in Patients With Inflammatory Bowel Disease Treated With Vedolizumab or Ustekinumab in Korea

Abstract

The present study investigated the risk of active tuberculosis in patients with inflammatory bowel disease (IBD) treated with vedolizumab or ustekinumab, in actual clinical settings in a country with an intermediate tuberculosis burden. The medical records of 238 patients with IBD who received vedolizumab or ustekinumab were retrospectively reviewed at a tertiary referral center in South Korea. All patients had ≥ 3 months of follow-up duration and underwent a latent tuberculosis infection screening test before initiation of the administration of these drugs. Of the 238 patients enrolled, 181 had Crohn’s disease, and 57 had ulcerative colitis. During the median 18.7 months of follow-up, active tuberculosis did not develop in any patient treated with vedolizumab or ustekinumab. Therefore, we concluded that the risk of tuberculosis appears to be low in patients with IBD treated with vedolizumab or ustekinumab in South Korea.

The safety of vedolizumab in a patient with Crohn’s disease who developed anti-TNF-alpha agent associated latent tuberculosis infection reactivation: A case report

“…[ 17 ] Furthermore, a retrospective study of patients with IBD with latent TB infection who received VDZ revealed no cases of active TB infection. [ 18 – 20 ] Choi et al reported a case of a pediatric patient with CD who successfully achieved and maintained remission with VDZ after developing pulmonary TB during infliximab treatment. This case report is very similar to the present case.…”

“…Three developed latent TB infection Bonovas et al (2016) [16] Meta-analysis N/A 461 Odds ratio of TB numerically higher with VDZ vs placebo (2.50, 95% CT, 0.06-104.43). Result did not reach statistical significance Amiot et al (2016) [17] Prospective observation study France 294 One patient developed TB infection (0.34%) despite a negative pretherapeutic screening Ramos et al (2018) [18] Retrospective study of IBD patients who received biologic with LTBI USA 7 None developed active TB infection (0%) in 7 patients treated with VDZ Kim et al (2021) [19] Retrospective study of IBD patients who developed LTBI Korea 47 Positive IGRA conversion was observed in 4 patients (8.5%), none of the 4 converters developed active TB infection Choi et al (2022) [20] Retrospective study (real world data) Korea 125 None developed active TB infection (0%) in patients treated with VDZ Choi et al (2021) [21] Case report Korea VDZ is a humanized monoclonal antibody that selectively binds to the α 4 β 7 integrin. VDZ inhibits lymphocyte adhesion to mucosal addressin cell adhesion molecule-1 and subsequent migration.…”

IBD barriers across the continents – East Asia

“…39 Relatively, other biologics such as ustekinumab and vedolizumab, have lower rates of latent tuberculosis reactivation. 40 Tuberculosis infection can be disseminated and fatal. 36 Therefore, with the high popularity of anti-TNF agents in East Asia, reactivation of latent tuberculosis is a main concern before biologics initiation.…”

Tuberculosis infection in patients with inflammatory bowel diseases. Clinacal cases

“…M. Choi и соавт. предлагают рассматривать эти препараты в качестве оптимального выбора для больных с ВЗК в странах, где бремя ТБ является значительным [17].…”