Clinical Efficacy of Early and Late Vedolizumab or Infliximab Interventions in Moderate Ulcerative Colitis: A Multicenter, Retrospective Cohort Study

Background: Late biologic intervention has been partly displaced during the last decade by early biologic therapy. However, there is a scarcity of direct evidence to inform clinical decision-making with greater confidence. The study aimed to compare the efficacy and safety of the early biologic approach with those of the late biologic approach in patients with moderate ulcerative colitis (UC). Methods: Moderate UC patients treated with biologics between January 2021 and February 2024 from three Chinese centers were retrospectively included. The outcomes included steroid-free clinical remission rates, clinical remission rates, and mucosal healing rates at week 14 and week 52. Results: A total of 124 moderate UC cases were included. No marked differences in the steroid-free clinical remission rates and clinical remission rates were observed between the two groups at week 14 or at week 52 (P > 0.050). The early biologic therapy group exhibited a numerically higher mucosal healing rate at week 14 (23.3% vs. 12.5%, P = 0.115) and week 52 (15/27 (55.6%) vs. 13/37 (35.1%), P = 0.104) compared to the late biologic therapy group, yet there was no significant difference between two groups. Conclusion: No significant differences in steroid-free clinical remission, clinical remission, and mucosal healing were observed between early and late biologic intervention group.