Vedolizumab in combination with thiopurines is less likely to result in treatment failure than vedolizumab alone for Crohn’s disease — but not ulcerative colitis, a study shows.

In their report on the first population-based study of its kind, US researchers say their findings will help guide clinical decision-making in patients with inflammatory bowel disease (IBD) starting biologic therapy.

Although evidence supports the use of infliximab with a thiopurine for these patients, the usefulness of adding thiopurines to vedolizumab has been controversial, they said.

To provide clarity, the team drew upon data from 10,000 vedolizumab users in three healthcare databases — two from the US and one from France — to compare the risk of treatment failure with combination therapy versus monotherapy for IBD.