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Immunological treatment failure of anti-TNF therapy negatively influences treatment persistence of a second anti-TNF in IBD patients. So far it is unknown if this effect is also observed for other monoclonal antibodies. We assessed the influence of immunogenicity to anti-TNFs on treatment persistence of subsequent ustekinumab and vedolizumab therapy. IBD patients with and without immunogenicity to anti-TNFs (undetectable trough levels and antibody titers ≥20 ng/mL) and subsequent ustekinumab (UST) and/or vedolizumab (VDZ) therapy were included in this retrospective, single-center study. The Kaplan-Meier method with the log-rank test and Cox proportional hazards were used as statistical methods. One hundred patients (Crohn’s disease: 62, Ulcerative colitis: 31, IBD unclassified: 7) with 127 treatment lines (62 with UST, 65 with VDZ) were included in the analysis. Immunogenicity to previous anti-TNFs did not influence treatment persistence of subsequent ustekinumab and vedolizumab therapy (UST: Log rank:  p  = .95, Immunogenicity: HR for treatment discontinuation: 0.97 [95% CI 0.31–3.04]; VDZ:  p  = .65, HR: 0.85 [0.41–1.75]; total cohort [UST and VDZ]:  p  = .62, HR: 0.86 [0.47–1.57]). Azathioprine co-treatment did not lengthen treatment persistence (UST: Log rank:  p  = .77, azathioprine: HR: 1.20 [0.34–4.27]; VDZ:  p  = .92, HR: 0.58 [0.17–1.99]; total cohort:  p  = .79, HR: 1.10 [0.55–2.20]). In this anti-TNF experienced cohort, patients with ustekinumab remained longer on treatment than patients receiving vedolizumab (Log rank:  p  = .005, UST: HR: 0.43 [0.23–0.79]). Immunogenicity to anti-TNFs does not influence treatment persistence of subsequent ustekinumab and vedolizumab therapy.

Treatment persistence of ustekinumab and vedolizumab in IBD patients is independent of prior immunogenicity to anti-TNFs: a retrospective study