| Autor: |
Mader, Orla, Juillerat, Pascal, Biedermann, Luc, Michetti, Pierre, Hruz, Petr, Pittet, Valerie, Rogler, Gerhard, Zahnd-Straumann, Nadine, Seibold, Frank |
| Zdroj: |
United European Gastroenterology Journal; 20240101, Issue: Preprints |
| Abstrakt: |
Background Vedolizumab (VDZ), a humanized monoclonal antibody against α4β7-integrin, has shown efficacy in inflammatory bowel disease (IBD). It is of importance to assess the mid- to long-term efficacy of VDZ using real-life data.Objective Our study aimed to determine the efficacy of VDZ in patients with IBD with and without prior exposure to anti-tumour necrosis factor (TNF) treatments in a real-life setting. Furthermore, we investigated confounding factors influencing the remission to VDZ.Methods Patients participating in the Swiss IBD Cohort Study were included in this study. Remission was defined as calprotectin <200 mg/kg stool and/or mucosal healing determined by endoscopy. End points were determined between months 4 and 8 (T1) and between months 12 and 16 (T2) after VDZ induction.Results Remission was reported in 50.5% (110/218) of patients in T1 (48.7% Crohn’s disease (CD) and 52.5% ulcerative colitis (UC)) and 46.8% (102/218) in T2 (47% CD and 46.5% UC). In UC patients, a significantly higher remission rate was achieved in T2 among anti-TNF-naive patients (57.7%) compared to anti-TNF-experienced patients (34.7%; p= 0.02; odds ratio=0.39, 95% confidence interval 0.17–0.87). In patients with CD, no difference could be seen in either evaluation intervals. Multivariable analysis showed that disease duration significantly influenced remission rates among UC patients. A late response to VDZ therapy with an achievement of remission in T2 was seen in a fifth of all patients (CD 21.7%, UC 20.8%). VDZ treatment was stopped in a third of all patients (31.8%) due to non-response, adverse events or aggravation of extra-intestinal manifestations.Conclusion In a real-life national cohort setting, VDZ induced remission in more than half of IBD patients. Previous treatment with anti-TNF agents was associated with a significant lower efficacy of VDZ in UC but not in CD patients. |
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