Abstract
BackgroundVedolizumab has become a standard treatment for the inflammatory bowel diseases ulcerative colitis (UC) and Crohn’s disease (CD). However, there is an ongoing debate on the ideal individual treatment algorithms and means to predict treatment response are not routinely established.AimsWe aimed to describe our experiences with vedolizumab at a large German tertiary referral center and to identify clinical predictors of success of vedolizumab treatment.MethodsWe performed a retrospective single-center cohort study employing univariable and multivariable analyses as well as Kaplan–Meier analyses of persistence on treatment.Results36% and 35% of the patients with UC and CD, respectively, reached clinical remission after 17 weeks. Patients with lower clinical disease activity were more likely to achieve remission. The median persistence on treatment was 33 months for UC and 29 months for CD.ConclusionOur study confirms that vedolizumab is an efficient option for the treatment of UC and CD. Clinical parameters of disease activity may help to predict the success of treatment.
Highlights
Vedolizumab has become a standard treatment for the inflammatory bowel diseases ulcerative colitis (UC) and Crohn’s disease (CD)
Our study confirms that vedolizumab is an efficient option for the treatment of UC and CD
After exclusion of 53 patients due to previous proctocolectomy (n = 10), inflammatory bowel diseases (IBD)-U (n = 10), microscopic colitis (n = 3), active enteroor colostoma (n = 12) or incomplete follow-up (n = 18), 181 patients were included into the analysis, 106 with UC and 75 with CD (Fig. 1)
Summary
Vedolizumab has become a standard treatment for the inflammatory bowel diseases ulcerative colitis (UC) and Crohn’s disease (CD). One of the standard therapy options for the treatment of both Crohn’s disease (CD) and ulcerative colitis (UC) is the anti-α4β7 integrin antibody vedolizumab. Vedolizumab has been shown to prevent the so-called gut homing process of α4β7-expressing immune cells, i.e. their extravasation from the blood to the intestinal tissue [15,16,17]. Due to this impact on circulating and not on resident immune cells, the onset of the effect is somewhat delayed in a considerable portion of the responding patients [10]. Vedolizumab is seen as a rather “slow-acting” antibody [18], further emphasizing the importance of a high a priori likelihood of success to avoid long ineffective treatment periods before the response or non-response can be reliably assessed
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