Vedolizumab Vs Adalimumab for Crohn’s and Ulcerative Colitis

Vedolizumab vs Adalimumab is the comparison of two anti-inflammatory medications that are used to treat autoimmune conditions. This article focuses on the efficacy of both drugs in the treatment of rheumatoid arthritis, ankylosing spondylitis, psoriasis, Crohn’s Disease (CD), and Ulcerative Colitis (UC).

Vedolizumab and Adalimumab are two newly approved, very potent biological medicines indicated for the treatment of various autoimmune rheumatic diseases.

These biological medicines are highly targeted and effective in inducing and maintaining remission in patients with moderate or severe active disease with greater safety and tolerability.

What is Vedolizumab?

Vedolizumab is a monoclonal antibody that is used in the treatment of inflammatory bowel diseases. It is an integrin receptor antagonist that binds to alpha-4 beta-7 integrin, which is primarily found on the surface of gut-homing T cells.

The drug prevents the migration of these T cells into inflamed tissue and reduces inflammation. Vedolizumab is sold under the brand name Entyvio and is administered through intravenous infusion.

What is Adalimumab?

Adalimumab is a biological drug that is used in the treatment of various autoimmune diseases. It binds to TNF-α receptors and blocks the production and activation of inflammatory cytokines.

Thus it relieves pain and inflammation related to autoimmune conditions like Rheumatoid arthritis and ankylosing spondylitis.

Adalimumab is sold under the brand name Humira and is administered through subcutaneous injection.

Comparative analysis of Vedolizumab Vs Adalimumab

To understand the comparative analysis of Vedolizumab and Adalimumab, we need to analyze them based on various parameters, such as efficacy, safety, cost, mode of administration, etc. Let’s take a look at each of these parameters in detail.

Efficacy of Vedolizumab Vs Adalimumab:

The efficacy of a drug is one of the most important parameters in the treatment of any disease. In the case of Vedolizumab and Adalimumab, both drugs have shown excellent efficacy in various autoimmune diseases. However, the efficacy of the two drugs may vary depending on the disease.

Vedolizumab Vs Adalimumab in Crohn’s Disease:

Crohn’s disease is an autoimmune disease affecting the GI tract primarily the large intestine. It can affect any part of the GI tract, unlike ulcerative colitis which only affects the large intestine.

Both Vedolizumab and Adalimumab are superior to a placebo medicine in inducing and maintaining remission in patients with Crohn’s disease.

Vedolizumab is more effective in the treatment of Crohn’s disease compared to Adalimumab.

Vedolizumab Vs Adalimumab in Rheumatoid Arthritis:

Rheumatoid arthritis is a very common autoimmune disease affecting small and large joints.

In an RCT (RA-BEGIN) that involved 1,629 patients with early rheumatoid arthritis, Adalimumab was found to be superior to Methotrexate (MTX) in inhibiting the radiographic progression of the disease.

Vedolizumab has not been studied extensively in the treatment of rheumatoid arthritis.

Vedolizumab Vs Adalimumab  in Ankylosing Spondylitis:

Ankylosing spondylitis is an autoimmune inflammatory condition of the spine, sacroiliac joints, hip, and other large joints.

Adalimumab has been found effective in the treatment of ankylosing spondylitis in various clinical trials, ABILITY-1 being one of the hallmark trials.

Adalimumab improves physical activity, reduces disability, and induces and maintains remission in patients with moderate to severely active Ankylosing spondylitis.

Vedolizumab has not been studied extensively in the treatment of ankylosing spondylitis.

Vedolizumab Vs Adalimumab in Ulcerative Colitis:

Ulcerative colitis is one of the common inflammatory conditions of bowls. It affects primarily the large intestine, colon, and rectum. It may rarely affect the small intestine which is called backwash ileitis.

Both Vedolizumab and Adalimumab are effective in the treatment of moderate to severely active ulcerative colitis.

However, Vedolizumab is more effective than Adalimumab in inflammatory conditions of the GI tract such as Crohn’s disease and Ulcerative colitis.

One of the landmark clinical trials that evaluated Entyvio Vs Humira was the Varsity Trial. The results of the Varsity Trial are tabulated below [Ref]:

The results show that vedolizumab was more effective than adalimumab in achieving clinical remission and endoscopic improvement in patients, with a statistically significant difference in favor of vedolizumab.

However, there was no statistically significant difference between the two drugs in achieving corticosteroid-free clinical remission.

Additionally, the exposure-adjusted incidence rates of infection and serious infection were lower with Vedolizumab (Entyvio) than with Adalimumab (Humira).

Vedolizumab Vs Adalimumab in Psoriasis:

Psoriasis is an autoimmune inflammatory condition affecting the skin and joints. In an RCT (VESTA) that involved 206 patients with moderate to severely active psoriasis, Vedolizumab was found to be non-inferior to placebo in reducing the severity of psoriasis.

Adalimumab has also been found to be effective in treating psoriasis. In a study that involved 1,211 patients with moderate to severely active psoriasis, Adalimumab was found to be significantly better than a placebo in reducing the severity of psoriasis.

As a result, it can be concluded that both Vedolizumab and Adalimumab are highly effective in treating autoimmune diseases. However, the efficacy of the drugs may vary depending on the disease.

Safety of Vedolizumab Vs Adalimumab:

The safety of a drug is another important parameter in the treatment of any disease. Both Vedolizumab and Adalimumab are generally safe and tolerable. However, both drugs can cause some adverse effects.

Vedolizumab commonly causes infusion-related reactions, headache, arthralgia, nausea, and nasopharyngitis. In rare cases, the drug may also cause serious infections, including tuberculosis, opportunistic infections, and the reactivation of the hepatitis B virus.

Adalimumab can lead to injection-site allergic reactions, nausea, flu, headache, and upper respiratory tract infections.

Because it suppresses the immune system, there is an increased risk of opportunistic infections such as tuberculosis, invasive bacterial and fungal infections, and the reactivation of the hepatitis B virus.

Both Vedolizumab and Adalimumab are generally well-tolerated and safe.

Cost of Vedolizumab Vs Adalimumab:

The cost of a drug is an important factor in the treatment of any disease, especially in chronic conditions. Both Vedolizumab and Adalimumab are expensive drugs, and their cost may vary depending on the country and the healthcare system.

In the United States, the average wholesale price of Vedolizumab is around $6,000 per infusion, and the drug is usually administered every 8 weeks. The annual cost of treatment with Vedolizumab can be around $36,000.

In the United States, the average wholesale price of Adalimumab is around $5,000 per month, and the drug is usually administered every 2 weeks. The annual cost of treatment with Adalimumab can be around $60,000.

On the basis of cost, Vedolizumab may be a more cost-effective option than Adalimumab for some autoimmune diseases, such as ulcerative colitis.

Comparison of Vedolizumab and Adalimumab:

Conclusion:

Vedolizumab and Adalimumab are two drugs that have revolutionized the treatment of autoimmune diseases.

Both drugs are highly effective in treating autoimmune diseases, including Crohn’s disease, ulcerative colitis, rheumatoid arthritis, psoriatic arthritis, psoriasis, ankylosing spondylitis, and hidradenitis suppurativa.

However one can be better than the other in certain conditions such as vedolizumab for ulcerative colitis and adalimumab for rheumatoid and psoriatic arthritis.

Both drugs have minimal side effects and somehow similar safety profiles. However, they can cause some adverse effects, and the risk of adverse effects may vary depending on the patient and the disease.