JAMA Netw Open

No major safety differences found among advanced Crohn's therapies

February 18, 2026

A large comparative‑effectiveness study of 12,245 patients with Crohn disease initiating advanced therapies (2016–2022) found no significant differences in the risks of serious infection, venous thromboembolism (VTE), or major adverse cardiovascular events (MACE) across TNF antagonists, vedolizumab, ustekinumab, risankizumab, or upadacitinib. Serious infection rates ranged from 5.46 to 9.02 per 100 person‑years, with adjusted hazard ratios [HRs] showing no meaningful differences (e.g., risankizumab vs. ustekinumab HR, 1.14; 95% confidence interval [CI], 0.78–1.67; ustekinumab vs. TNF antagonists HR, 0.88; 95% CI, 0.74–1.04). VTE and MACE rates were low across agents.

Clinical takeaway: With comparable safety across advanced therapies, clinicians can prioritize efficacy, prior biologic exposure, and patient‑centered factors when selecting treatment.

Source:

Park SK, et al. (2026, February 6). JAMA Netw Open. Comparative Safety of Advanced Therapies for Crohn Disease. https://pubmed.ncbi.nlm.nih.gov/41649814/