Abstract: TH-PO0842
Kidney Outcomes Among Patients with Inflammatory Bowel Disease Treated with Anti-Tumor Necrosis Factor vs. Gut-Selective Biologic Therapy: A Propensity-Matched TriNetX Analysis
Session Information
- Pharmacology (PharmacoKinetics, -Dynamics, -Genomics)
October 22, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Pharmacology (PharmacoKinetics, -Dynamics, -Genomics)
- 1900 Pharmacology (PharmacoKinetics, -Dynamics, -Genomics)
Authors
- Asaolu, Gideon, Northeast Georgia Health System Inc, Gainesville, Georgia, United States
- Ayinde, Bolaji, Northeast Georgia Health System Inc, Gainesville, Georgia, United States
- Chijioke, Chidinma Blossom, Saint Clare's Health System, Denville, New Jersey, United States
- Okachi, Simeon, Kingston Public Hospital, Kingston, St. Andrew Parish, Jamaica
- Aggarwal, Deepak K., Northeast Georgia Health System Inc, Gainesville, Georgia, United States
Background
Inflammatory bowel disease (IBD) is associated with extraintestinal renal complications including acute kidney injury (AKI), nephrolithiasis, and chronic kidney disease (CKD). Anti-tumor necrosis factor (anti-TNF) agents produce systemic immune modulation, whereas vedolizumab acts through gut-selective α4β7 integrin blockade with limited systemic effects. Whether these mechanistic differences influence renal outcomes over time remains unclear. We aim to explore renal outcomes among IBD patients treated with anti-TNF therapy versus vedolizumab.
Methods
We conducted a retrospective cohort study using the TriNetX US Collaborative Network comprising 67 healthcare organizations. Adults (≥18years) with Crohn disease or Ulcerative colitis were included. Patients with pre-existing CKD, ESRD, renal transplantation, lupus nephritis, nephrotic syndrome, or chronic nephropathies were excluded. Cohort 1 received anti-TNF therapy (infliximab, adalimumab, golimumab, or certolizumab), and Cohort 2 received vedolizumab, with exclusion of other advanced biologic and small-molecule therapies. Propensity score matching balanced baseline demographics and comorbidities. Primary outcomes included all cause mortality. Secondary outcomes included AKI, nephrolithiasis, and new-onset CKD.
Results
The study involved 20,712 adult patients with median age of 41, 51% accounting for females. For AKI, rates were similar between the anti-TNF and vedolizumab groups at 6 months and at 1 year; however, by 2 years, AKI occurred more frequently in the anti-TNF cohort (2.2% vs 1.7%; RR 1.285, 95% CI 1.043–1.585; HR 1.276, 95% CI 1.033–1.576; p=0.024). Nephrolithiasis rates were higher in the anti-TNF group at 6 months and at 1 year, at 2 years, the rates were comparable. New onset CKD events were not observed and did not differ between cohorts during follow-up.
Conclusion
In this study of patients with IBD, cohort 1 was associated with higher AKI risk at 2 years compared with cohort 2. These findings suggest differential renal risk profiles between systemic and gut-selective biologic therapies and support renal monitoring in biologic-treated IBD patients. Further research is required for better understanding of possible time dependent side effects.