Journal
DIGESTIVE AND LIVER DISEASE
Volume 50, Issue 12, Pages 1299-1304Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.dld.2018.07.007
Keywords
Biological therapy; Clinical predictors; Crohn's disease; Elderly; Immunomodulator; Ulcerative colitis
Categories
Funding
- University of Pavia
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Background: Real-life data on vedolizumab effectiveness in inflammatory bowel disease (IBD) are still emerging. Data on the comparative safety of the gut selective profile are of particular interest. Aims: To assess clinical outcome and safety in IBD patients treated with vedolizumab. Methods: We retrospectively collected data of patients treated with vedolizumab at eight UK hospitals (August 2014-January 2018). Clinical response and remission at 14 and 52 weeks evaluated through Physician Global Assessment (PGA) and adverse events were recorded. Possible predictors of clinical response were examined. Results: Two hundred and three IBD patients (mean treatment 16 + 8 months) were included. Of these, 135 patients (mean age 40.6 + 16.0 years; F:M 1.9:1) had CD and 68 (mean age 44.5 + 18.1 years; F:M 1:1.2) had UC. According to PGA, 106/135 (78.5%) CD and 62/68 (91.2%) UC patients (p = 0.02) had a clinical response/remission at 14 weeks, whereas 76/119 (63.9%) CD and 52/63 (82.5%) UC patients (p < 0.01) showed a sustained response or remission at 52 weeks, with a high adherence rate (97%). No predictors of clinical response were found. The cumulative incidence of infectious diseases was 11.9 per 100 person years. Conclusion: Vedolizumab is an effective therapy for inducing and maintaining remission of IBD, with better results for UC, and with a good safety profile. (C) 2018 The Authors. Published by Elsevier Ltd on behalf of Editrice Gastroenterologica ltaliana S.r.l.
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