Objective:

To evaluate the safety profiles of various advanced therapies for Crohn's disease in a real-world setting.

Key Findings:

• No significant differences in rates of serious infections, venous thromboembolism, or major adverse cardiovascular events across therapies.
• Serious infections occurred at rates of 5 to 9 events per 100 person-years.
• Ustekinumab showed a lower risk of gastrointestinal serious infections compared to vedolizumab.
• Venous thromboembolism rates were low, around 1 event per 100 person-years.
• Major adverse cardiovascular events were rare, below 2 events per 100 person-years.

Interpretation:

The safety profiles of advanced Crohn's therapies are broadly similar, suggesting that clinicians can choose among these therapies without significant concern for differing safety risks.

Limitations:

• Reliance on administrative claims data without measures of disease activity.
• Potential residual confounding.
• Low event rates for cardiovascular and thromboembolic outcomes.
• Shorter follow-up for newer agents like risankizumab.

Conclusion:

The study indicates comparable safety across advanced therapies for Crohn's disease, aiding in treatment decision-making.