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Long-term effectiveness of vedolizumab in inflammatory bowel disease: a national study based on the Swedish National Quality Registry for Inflammatory Bowel Disease (SWIBREG)
Örebro University, Sweden.
Lund University, Sweden; Skåne University Hospital, Sweden.
Örebro University, Sweden.
Ystad Hospital, Sweden.
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2017 (English)In: Scandinavian Journal of Gastroenterology, ISSN 0036-5521, E-ISSN 1502-7708, Vol. 52, no 6-7, 722-729 p.Article in journal (Refereed) Published
Abstract [en]

Objectives: Clinical trials have demonstrated the efficacy of vedolizumab in inflammatory bowel disease (IBD). However, these findings may not reflect the clinical practice. Therefore, we aimed to describe a vedolizumab-treated patient population and assess long-term effectiveness.Materials and methods: Patients initiating vedolizumab between 1 June 2014 and 30 May 2015 were identified through the Swedish National Quality Registry for IBD. Prospectively collected data on treatment and disease activity were extracted. Clinical remission was defined as Patient Harvey Bradshaw indexamp;lt;5 in Crohns disease (CD) and Patient Simple Clinical Colitis Activity indexamp;lt;3 in ulcerative colitis (UC).Results: Two-hundred forty-six patients (147CD, 92 UC and 7 IBD-Unclassified) were included. On study entry, 86% had failed TNF-antagonist and 48% of the CD patients had undergone1 surgical resection. After a median follow-up of 17 (IQR: 14-20) months, 142 (58%) patients remained on vedolizumab. In total, 54% of the CD- and 64% of the UC patients were in clinical remission at the end of follow-up, with the clinical activity decreasing (pamp;lt;.0001 in both groups). Faecal-calprotectin decreased in CD (pamp;lt;.0001) and in UC (p=.001), whereas CRP decreased in CD (p=.002) but not in UC (p=.11). Previous anti-TNF exposure (adjusted HR: 4.03; 95% CI: 0.96-16.75) and elevated CRP at baseline (adjusted HR: 2.22; 95% CI: 1.10-4.35) seemed to be associated with discontinuation because of lack of response. Female sex was associated with termination because of intolerance (adjusted HR: 2.75; 95% CI: 1.16-6.48).Conclusion: Vedolizumab-treated patients represent a treatment-refractory group. A long-term effect can be achieved, even beyond 1 year of treatment.

Place, publisher, year, edition, pages
TAYLOR & FRANCIS LTD , 2017. Vol. 52, no 6-7, 722-729 p.
Keyword [en]
Vedolizumab; clinical practice; inflammatory bowel disease; Crohns disease; ulcerative colitis
National Category
Gastroenterology and Hepatology
Identifiers
URN: urn:nbn:se:liu:diva-137628DOI: 10.1080/00365521.2017.1304987ISI: 000399808100018PubMedID: 28362144OAI: oai:DiVA.org:liu-137628DiVA: diva2:1097335
Note

Funding Agencies|Swedish Government [OLL-549221, OLL-526131, ALFSKANE-539811]; Hedlund Foundation; Osterlund Foundation

Available from: 2017-05-22 Created: 2017-05-22 Last updated: 2017-05-22

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Myrelid, Pär
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Division of Surgery, Orthopedics and OncologyFaculty of Medicine and Health SciencesDepartment of Surgery in Linköping
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CiteExportLink to record
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