Literature DB >> 28839909

Vedolizumab: early experience and medium-term outcomes from two UK tertiary IBD centres.

Mark A Samaan1, Polychronis Pavlidis2, Emma Johnston1, Ben Warner1, Jonathan Digby-Bell1, Ioannis Koumoutsos1, Steven Fong1, Rimma Goldberg1, Kamal Patel1, Shraddha Gulati2, Lucy Medcalf2, Marlene Sastrillo1, Cordella Brown-Clarke1, Johanna Bidewell-Sullivan1, Katrina Forsyth1, Emma Lee1, Anna Stanton1, Julie Duncan1, Guy Chung-Faye2, Patrick Dubois2, Nick Powell1, Simon Anderson1, Jeremy Sanderson1, Bu'Hussain Hayee2, Peter M Irving1.   

Abstract

OBJECTIVE: To gain an understanding of the efficacy of vedolizumab in a 'real-world' setting.
DESIGN: Retrospective cohort study using prospectively maintained clinical records.
SETTING: Two UK tertiary inflammatory bowel disease (IBD) centres. PATIENTS: Patients with IBD commenced on vedolizumab at Guy's & St Thomas' and King's College Hospitals during November 2014-November 2015. INTERVENTION: Vedolizumab, a monoclonal antibody to α-4 β-7 integrins that selectively inhibit leucocyte migration into the gut. MAIN OUTCOME MEASURES: Clinical disease activity was assessed at baseline, weeks 14 and 30 using Harvey-Bradshaw Index (HBI) for Crohn's disease (CD) and Simple Clinical Colitis Activity Index (SCCAI) for ulcerative colitis (UC). Response was defined as HBI or SCCAI reduction ≥3. Remission was defined as HBI <5 or SCCAI <3. Continuous data are summarised as medians, followed by range.
RESULTS: Fifty patients were included: 27 CD, 20 UC and 3 IBD-U (included in the UC group for analysis). At baseline visit, the median HBI was 8 (1-16) and SCCAI was 6 (0-15). At week 14, these values had fallen to 5 (0-15) (p=0.117) and 4 (0-10) (p=0.005), respectively. Additionally, week 30 data were available for 19 patients (9 CD, 10 UC). The clinical disease activity scores at that point were HBI 2 (0-7) (p=0.039) and SCCAI 2 (0-10) (p=0.023). At baseline, 37 (74%) of the 50 patients had clinically active disease. Of the patients with active disease, 22 (59%) responded and 14 (38%) achieved remission at week 14.
CONCLUSIONS: Our early experience with vedolizumab demonstrates a clear benefit in terms of disease control as well as a steroid-sparing effect in a cohort, which included patients with complex and previously refractory disease.

Entities:  

Keywords:  CROHN'S DISEASE; INFLAMMATORY BOWEL DISEASE; ULCERATIVE COLITIS

Year:  2016        PMID: 28839909      PMCID: PMC5558276          DOI: 10.1136/flgastro-2016-100720

Source DB:  PubMed          Journal:  Frontline Gastroenterol        ISSN: 2041-4137


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