A head-to-head comparison of adalimumab and vedolizumab for the treatment of ulcerative colitis finds vedolizumab is superior for clinical remission and endoscopic improvement, but not in achieving corticosteroid remission.

The double-blinded trial — known as VARSITY and funded by Takeda, the maker of vedolizumab — was carried out in 245 centres across 34 countries, including Australia.

Nearly 770 patients with moderate to severe disease were randomised to the two biologics, with major endpoints assessed after a year on treatment.

At one-year follow-up, 31.3% of patients on vedolizumab and 22.5% receiving adalizumab were in clinical remission, defined as a total score of two or less on the Mayo scale (range 0-12, higher more severe), with none of the four subscores greater than one.