Interpreting vedolizumab persistence: lessons from real-world trajectories in ulcerative colitis

severity were not associated with LOR.Importantly, persistence was consistent across both biologic-naive and previously exposed patients, underscoring the broad utility of VDZ in clinical practice.The results align with other real-world data.Despite inherent limitations of claims-based studies, a large Japanese analysis demonstrated 12-month persistence rates of 69.7% for VDZ; lower than ustekinumab (84.0%), but comparable to tofacitinib (61.6%), infliximab (62.9%), adalimumab (57.6%) and golimumab (54.9%).4 Likewise, Scottish real-world data showed VDZ persistence of 80.7% at 1 year, gradually declining to 47.9% over 5 years.5 Viewed collectively, this Japanese multicenter study suggests VDZ persistence in Asian populations is broadly comparable-albeit slightly lower-to Western cohorts, and comparable to other advanced biologics.Beyond persistence related to efficacy, VDZ is widely recognized for its favorable safety profile, attributable to its gut-selective mechanism.This characteristic often makes VDZ a preferred biologic option for elderly patients in many countries.These real-world data analyses by Kobayashi et al. 3 support comparable persistence across age groups.In another study by a large Japanese claims dataset, patients prescribed VDZ were older than those receiving anti-TNF agents, yet persistence remained independent of age. 4 This is consistent with the post hoc analysis of GEMINI, which demonstrated no significant age-related differences in safety or efficacy.6 Whereas immunogenicity is the most common cause of secondary LOR in anti-TNF agents, the mechanisms underly-