Crohn’s disease, disease burden may weaken vedolizumab efficacy in IBD patients
Vedolizumab is safe and effective in the treatment of inflammatory bowel disease (IBD) patients, according to a study. However, Crohn’s disease (CD) and a more severe disease appear to impair both short- and long-term effectiveness of the drug.
Researchers looked at 508 patients (median age 42 years; 54.8 percent female; 50.9 percent had CD) who received ≥1 induction dose of vedolizumab, with a median follow-up of 10 months. Effectiveness was measured using the Harvey-Bradshaw index (HBI) in CD and the Partial Mayo Score (PMS) in ulcerative colitis (UC). Responses to treatment in the short term (week 14) and the long-term were evaluated.
Overall, 46.8 percent of patients achieved remission while 15.7 percent had clinical response at week 14. CD, previous surgery, higher C-reactive protein (CRP) concentration and greater disease severity at baseline emerged as significant predictors of impaired response.
Vedolizumab discontinuation rate was 37 percent per patient-year of follow-up (27.6 percent in UC; 45.3 percent in CD; p<0.01). Factors significantly associated with lower treatment durability included CD, anaemia at baseline, steroids during induction and CRP concentration.
Adverse events occurred in 7.1 percent of patients overall. The most commonly reported were infections such as those of the sinopulmonary and gastrointestinal tracts.
Additional clinical trials are needed to place vedolizumab in the therapeutic algorithm of IBD patients, researchers said.