November 02, 2026
2 min read
Chaudhry N, et al. Real-world comparative effectiveness of TNF inhibitors, vedolizumab, and JAK inhibitors in ulcerative colitis: A propensity score-weighted analysis. Presented at: ACG Annual Scientific Meeting; Oct. 12-14, 2026; Nashville, Tenn. (hybrid meeting).
Key Takeaways
- JAK inhibitors are associated with improved outcomes in patients with UC when compared with TNF inhibitors.
- Treatment-refractory disease did not inhibit the benefits associated with JAK inhibitors.
NASHVILLE, Tenn. — JAK inhibitors are associated with meaningful clinical and endoscopic outcomes compared with TNF inhibitors in patients with ulcerative colitis, according to findings presented at ACG Annual Scientific Meeting.
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“Ulcerative [colitis] treatment now includes multiple advanced therapy classes. But in real world practice, patients are not treated like randomized trial participants,” Naveed Chaudhry, DO, an internal medicine resident at Baylor Scott & White Medical Center in Texas, told attendees. “Treatment selection is influenced by prior biologic failure, steroid dependence and disease severity. We wanted to understand how these therapies perform in routine clinical care.”
For the single-center retrospective cohort study, Chaudry and colleagues enrolled 390 patients with ulcerative colitis who initiated either TNF inhibitors, vedolizumab (Entyvio; Takeda) or JAK inhibitors between 2020 and 2025.
The primary outcome included a 52-week steroid-free clinical remission with a Mayo score of equal to or less than 2 and no systemic corticosteroid use during follow-up. Treatment failure, hospitalization, steroid restart, ED visits and endoscopic healing were the secondary outcomes.
The researchers highlighted greater baseline disease severity and higher rates of prior biologic exposure in patients receiving JAK inhibitors compared with patients receiving TNF inhibitors or vedolizumab. Despite this, patients receiving JAK inhibitors showed higher 52-week steroid-free clinical remission compared with patients receiving TNF inhibitors (RR = 1.68; 95% CI, 1.29%–2.2%; P < 0.001), while those receiving vedolizumab demonstrated a non-significant trend toward improved remission (relative risk = 1.23; 95% CI, 0.98%–1.54%, P = 0.074).
Prior biologic exposure was associated with lower rates of remission, the researchers wrote. Moreover, JAK inhibitors corresponded to lower risks of treatment failure, steroid restart, ED visits and hospitalization when compared with TNF inhibitors.
For patients with endoscopic follow up, higher rates of endoscopic healing (RR = 1.42; P = 0.012) and complete mucosal healing (RR = 1.58; P = 0.035) were associated with JAK inhibitors.
“Clinically, these findings support the real-world effectiveness of JAK inhibitors in ulcerative colitis and suggest they may provide meaningful benefit, even after prior advanced therapy exposure,” Chaudhry said.
However, because of the study design and other factors, he cautioned that the findings should be interpreted as “association rather than proof of superiority.”
Sources/Disclosures
Disclosures:
Chaudhry reports no relevant disclosures.
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