Singh S, et al. - In patients with inflammatory bowel diseases (IBD), researchers assessed the comparative risk of serious infections with tumor necrosis factor (TNF) antagonists, non-TNF targeted biologics, tofacitinib, and immunosuppressive agents (thiopurines, methotrexate). According to this systematic review and meta-analysis, infliximab-based therapy in patients with ulcerative colitis, but not Crohn's disease, was related to a lower risk of serious infections compared to adalimumab-based therapy. Investigators found that combination therapies for IBD that include TNF antagonists, particularly with corticosteroids, were related to a higher risk of serious infection. On the other hand, monotherapy with an immunosuppressive agent was linked to lower risk, vs monotherapy with a TNF antagonist. Studies are required to assess the comparative safety for IBD treatment of non-TNF targeted biologics and small molecules. Few data on the comparative safety of biological agents not inhibiting TNF and tofacitinib were available.