Early Versus Late Use of Vedolizumab in Ulcerative Colitis: Clinical, Endoscopic, and Histological Outcomes.

Autor:	Vermeire S; Department of Gastroenterology and Hepatology, Department of Chronic Diseases and Metabolism, University Hospitals Leuven, KU Leuven, Leuven, Belgium., Hanzel J; Department of Gastroenterology, UMC Ljubljana, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia., Löwenberg M; Department of Gastroenterology and Hepatology, Amsterdam University Medical Center, Amsterdam, The Netherlands., Ferrante M; Department of Gastroenterology and Hepatology, Department of Chronic Diseases and Metabolism, University Hospitals Leuven, KU Leuven, Leuven, Belgium., Bossuyt P; Imelda Clinical Research Centre, Imelda General Hospital, Bonheiden, Belgium., Hoentjen F; Department of Gastroenterology, Radboud University Medical Centre, Nijmegen, The Netherlands.; Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, AB, Canada., Franchimont D; Department of Gastroenterology, Erasme Hospital, Brussels, Belgium., Palatka K; Division of Gastroenterology, Department of Internal Medicine, University of Debrecen, Debrecen, Hungary., Peeters H; Department of Gastroenterology, AZ Sint Lucas, Gent, Belgium., Mookhoek A; Institute of Tissue Medicine and Pathology, Bern University, Bern, Switzerland., de Hertogh G; Department of Pathology, University Hospitals Leuven, Leuven, Belgium., Molnár T; Division of Gastroenterology, Department of Medicine, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary., van Moerkercke W; Department of Gastroenterology and Hepatology, Department of Chronic Diseases and Metabolism, University Hospitals Leuven, KU Leuven, Leuven, Belgium.; Department of Gastroenterology, AZ Groeninge, Kortrijk, Belgium., Lobatón T; Department of Gastroenterology and Hepatology, University Hospital Gent, Gent, Belgium.; Department of Internal Medicine and Pediatrics, Gent University, Gent, Belgium., Clasquin E; Department of Gastroenterology and Hepatology, Amsterdam University Medical Center, Amsterdam, The Netherlands., Hulshoff MS; Department of Gastroenterology and Hepatology, Amsterdam University Medical Center, Amsterdam, The Netherlands., Baert F; Department of Gastroenterology, AZ Delta, Roeselare, Belgium., D'Haens G; Department of Gastroenterology and Hepatology, Amsterdam University Medical Center, Amsterdam, The Netherlands.
Jazyk:	angličtina
Zdroj:	Journal of Crohn's & colitis [J Crohns Colitis] 2024 Apr 23; Vol. 18 (4), pp. 540-547.
DOI:	10.1093/ecco-jcc/jjad179
Abstrakt:	Background and Aims: We explored the potential for differential efficacy of vedolizumab between early and late ulcerative colitis [UC] with evaluation of clinical, endoscopic, and histological endpoints. Methods: This was a multicentre, multinational, open-label study in patients with moderately-to-severely active UC, defining early UC by a disease duration <4 years and bio-naïve and late UC by a disease duration > 4 years and additional exposure to tumour necrosis factor antagonists. Patients received standard treatment with intravenous vedolizumab for 52 weeks [300 mg Weeks 0, 2, 6, every 8 weeks thereafter without escalation]. The primary endpoint was corticosteroid-free clinical remission with endoscopic improvement [total Mayo score ≤2 with no subscore >1] at both Weeks 26 and 52. Results: A total of 121 patients were included: in the "early" group, 25/59 [42.4%] achieved the primary endpoint versus 19/62 [30.6%] in the "late" group [p = 0.18]. There were no significant differences between the two groups in endoscopic improvement [Week 26: "early" 32/59 [54.2%] versus "late" 29/62 [46.8%]; p = 0.412; Week 52: 27/59 [45.8%] versus 25/62 [40.3%]; p = 0.546] or in histological remission [Robarts Histopathology Index <3 without neutrophils in the epithelium and lamina propria] [Week 26: 24/59 [40.7%] versus 21/62 [33.9%]; p = 0.439; Week 52: 22/59 [37.3%] versus 22/62 [35.5%]; p = 0.837]. Conclusions: No significant differences in clinical, endoscopic, and histological outcomes were observed between "early" and "late" disease. (© The Author(s) 2023. Published by Oxford University Press on behalf of European Crohn’s and Colitis Organisation. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
Databáze:	MEDLINE
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