Am J Gastroenterol

Anti-interleukins and JAK inhibitors show lower infection risk in ulcerative colitis patients

October 30, 2025

Study details: This retrospective cohort study analyzed 9,430 patients with ulcerative colitis (UC) initiating tumor necrosis factor-α (TNF) antagonists, anti-integrins, anti-interleukins, Janus kinase (JAK) inhibitors, or sphingosine-1 phosphate receptor (S1PR) modulators between 2016 and 2022, using the OptumLabs® Data Warehouse. Patients had at least one year of follow-up before and after therapy initiation. Multinomial propensity score-based inverse probability weighting adjusted for confounders, and cause-specific hazard ratios were calculated for serious infections, VTE, and MACE.

Results: Over a median 27 months, anti-interleukins were associated with a significantly lower risk of serious infections compared with TNF antagonists (hazard ratio [HR], 0.66; 95% confidence interval [CI], 0.51-0.87) and anti-integrins (HR, 0.75; 95% CI, 0.57-0.98). JAK inhibitors also showed lower infection risk vs. TNF antagonists (HR, 0.66; 95% CI, 0.46-0.94). Incidence rates of VTE (1.4–2.0/100 person-years) and MACE (0.5–1.0/100 person-years) were very low, with no significant differences across drug classes.

Clinical impact: Anti-interleukins and JAK inhibitors may offer a net safety benefit regarding serious infections, especially in patients previously exposed to TNF antagonists.

Source:

Ahuja D, et al. (2025, October 22). Am J Gastroenterol. Comparative Safety of Advanced Therapies in Patients with Ulcerative Colitis: An Administrative Claims-based Study. https://pubmed.ncbi.nlm.nih.gov/41124702/