D C Baumgart1, B Bokemeyer2, A Drabik3, A Stallmach4, S Schreiber5. 1. Department of Gastroenterology and Hepatology, Charité Medical School, Humboldt-University of Berlin, Berlin, Germany. 2. Gastroenterology Practice, Minden, Germany. 3. Biostatistics Consulting, Münster, Germany. 4. Department of Internal Medicine IV (Gastroenterology, Hepatology and Infectious Diseases), University Hospital Jena, Jena, Germany. 5. Department Internal Medicine I, University Hospital Schleswig-Holstein Campus, Kiel University of Schleswig-Holstein, Kiel, Germany.
Abstract
BACKGROUND: Vedolizumab (VDZ) is a humanised monoclonal IgG1 antibody targeting α4 β7 integrin. AIM: To investigate the real-world efficacy of vedolizumab for the treatment of Crohn's disease (CD) and ulcerative colitis (UC). METHODS: A consecutive cohort of 212 adult IBD patients with active disease (HBI >7/partial Mayo >4) newly receiving VDZ was prospectively recruited from 7 academic and 17 community centres. The primary endpoint was clinical remission (CRM) (CD HBI ≤4, UC pMayo ≤1) in week 14. Secondary endpoints included steroid-free remission (SFCRM), clinical response (CRS) (HBI/pMayo score drop ≥3), vedolizumab impact on CRP, calprotectin and haemoglobin. RESULTS: Data of 97 CD (71.1% female, HBI 11) and 115 UC (42.6% female, pMayo 6) patients were analysed. Only 5.2% CD and 24.3% UC were anti-TNFα naïve. Most had extensive mucosal involvement (Montreal L3 69.1%/E3 53.9%). At week 14, 23.7% vs. 23.5% of CD vs. UC patients achieved CRM, 19.6% vs. 19.1% SFCRM and 60.8% vs. 57.4% CRS, respectively (all based on NRI). Week 14 CRM in CD was significantly associated with no history of extraintestinal manifestations (P = 0.019), no prior adalimumab use (P = 0.011), no hospitalisation in the past 12 months (P = 0.015) and low HBI score (P = 0.02) and in UC with active or previous smoking (P = 0.044/0.028) and no anti-TNFα (P = 0.023) use. Low HBI (P = 0.019) and no hospitalisation in the past 12 months (P = 0.01) predict CD CRM. The three most common AE were joint pain, acne and nasopharyngitis. CONCLUSION: Vedolizumab is effective in routine use.
BACKGROUND:Vedolizumab (VDZ) is a humanised monoclonal IgG1 antibody targeting α4 β7 integrin. AIM: To investigate the real-world efficacy of vedolizumab for the treatment of Crohn's disease (CD) and ulcerative colitis (UC). METHODS: A consecutive cohort of 212 adult IBDpatients with active disease (HBI >7/partial Mayo >4) newly receiving VDZ was prospectively recruited from 7 academic and 17 community centres. The primary endpoint was clinical remission (CRM) (CD HBI ≤4, UC pMayo ≤1) in week 14. Secondary endpoints included steroid-free remission (SFCRM), clinical response (CRS) (HBI/pMayo score drop ≥3), vedolizumab impact on CRP, calprotectin and haemoglobin. RESULTS: Data of 97 CD (71.1% female, HBI 11) and 115 UC (42.6% female, pMayo 6) patients were analysed. Only 5.2% CD and 24.3% UC were anti-TNFα naïve. Most had extensive mucosal involvement (Montreal L3 69.1%/E3 53.9%). At week 14, 23.7% vs. 23.5% of CD vs. UC patients achieved CRM, 19.6% vs. 19.1% SFCRM and 60.8% vs. 57.4% CRS, respectively (all based on NRI). Week 14 CRM in CD was significantly associated with no history of extraintestinal manifestations (P = 0.019), no prior adalimumab use (P = 0.011), no hospitalisation in the past 12 months (P = 0.015) and low HBI score (P = 0.02) and in UC with active or previous smoking (P = 0.044/0.028) and no anti-TNFα (P = 0.023) use. Low HBI (P = 0.019) and no hospitalisation in the past 12 months (P = 0.01) predict CD CRM. The three most common AE were joint pain, acne and nasopharyngitis. CONCLUSION:Vedolizumab is effective in routine use.
Authors: Emily Becker; Sebastian Schramm; Marie-Theres Binder; Clarissa Allner; Maximilian Wiendl; Clemens Neufert; Imke Atreya; Markus Neurath; Sebastian Zundler Journal: J Vis Exp Date: 2018-09-20 Impact factor: 1.355
Authors: B Christensen; D Micic; P R Gibson; A Yarur; E Bellaguarda; P Corsello; J N Gaetano; J Kinnucan; V L Rao; S Reddy; S Singh; J Pekow; D T Rubin Journal: Aliment Pharmacol Ther Date: 2018-01-29 Impact factor: 8.171