Faculty mentor/PI email address
Yschneid@virtua.org
Is your research Teaching and Learning based?
1
Keywords
Colon Cancer, IBD, Monoclonal Antibodies, Adalimumab, Vedolizumab, Ustekinumab
Date of Presentation
5-6-2026 12:00 AM
Poster Abstract
Background: Inflammatory bowel disease (IBD) is associated with increased colorectal cancer (CRC) risk, but comparative neoplastic risks across biologic classes remain uncertain. We evaluated 5-year risks of CRC and GI neoplasia in IBD patients treated with adalimumab versus vedolizumab and ustekinumab using real-world data.
Methods: Using the TriNetX Global Collaborative Network, two parallel 5-year propensity score–matched cohort analyses were conducted among adults with Crohn's disease or ulcerative colitis initiating adalimumab, vedolizumab, or ustekinumab between 2018–2024, excluding patients with prior CRC or colectomy. The adalimumab–vedolizumab analysis matched 13,292 patients per cohort; the adalimumab–ustekinumab analysis matched 14,591 per cohort. Primary outcomes were incident CRC, other GI cancers, and colon polyps. Secondary outcomes included colectomy, GI dysplasia, and all-cause mortality. Five-year cumulative risks, risk ratios (RR), and risk differences (RD) were estimated.
Results: CRC incidence was low and statistically similar across all three biologics (adalimumab vs. vedolizumab: 0.19% vs. 0.25%, RR 0.76, p=0.29; adalimumab vs. ustekinumab: 0.21% vs. 0.29%, RR 0.71, p=0.16). Adalimumab was associated with fewer other GI cancers and colon polyps versus vedolizumab (p=0.01 and p< 0.001, respectively), but similar rates versus ustekinumab. Adalimumab demonstrated lower colectomy and GI dysplasia rates versus ustekinumab (both p< 0.01). Mortality did not differ significantly in either comparison.
Conclusions: All three biologics demonstrated similarly low CRC risk in IBD. Adalimumab showed modest advantages over vedolizumab in GI neoplasia and over ustekinumab in surgical and dysplasia outcomes. Prospective studies are needed to confirm these class-specific differences.
Disciplines
Digestive System Diseases | Medicine and Health Sciences | Neoplasms
Included in
Risk of colorectal and gastrointestinal neoplasia in inflammatory bowel disease treated with adalimumab versus vedolizumab and ustekinumab: a 5-year multicenter retrospective cohort study
Background: Inflammatory bowel disease (IBD) is associated with increased colorectal cancer (CRC) risk, but comparative neoplastic risks across biologic classes remain uncertain. We evaluated 5-year risks of CRC and GI neoplasia in IBD patients treated with adalimumab versus vedolizumab and ustekinumab using real-world data.
Methods: Using the TriNetX Global Collaborative Network, two parallel 5-year propensity score–matched cohort analyses were conducted among adults with Crohn's disease or ulcerative colitis initiating adalimumab, vedolizumab, or ustekinumab between 2018–2024, excluding patients with prior CRC or colectomy. The adalimumab–vedolizumab analysis matched 13,292 patients per cohort; the adalimumab–ustekinumab analysis matched 14,591 per cohort. Primary outcomes were incident CRC, other GI cancers, and colon polyps. Secondary outcomes included colectomy, GI dysplasia, and all-cause mortality. Five-year cumulative risks, risk ratios (RR), and risk differences (RD) were estimated.
Results: CRC incidence was low and statistically similar across all three biologics (adalimumab vs. vedolizumab: 0.19% vs. 0.25%, RR 0.76, p=0.29; adalimumab vs. ustekinumab: 0.21% vs. 0.29%, RR 0.71, p=0.16). Adalimumab was associated with fewer other GI cancers and colon polyps versus vedolizumab (p=0.01 and p< 0.001, respectively), but similar rates versus ustekinumab. Adalimumab demonstrated lower colectomy and GI dysplasia rates versus ustekinumab (both p< 0.01). Mortality did not differ significantly in either comparison.
Conclusions: All three biologics demonstrated similarly low CRC risk in IBD. Adalimumab showed modest advantages over vedolizumab in GI neoplasia and over ustekinumab in surgical and dysplasia outcomes. Prospective studies are needed to confirm these class-specific differences.