P644 Effectiveness of vedolizumab on intestinal outcomes and articular manifestations: Real-world data from the Sicilian Network for inflammatory bowel disease (SN-IBD)

Abstract

Vedolizumab (VDZ) is a biologic agent approved for the treatment of adult patients with moderately to severely active ulcerative colitis (UC) or Crohn’s disease (CD). The effectiveness of the drug in real-world practice is currently under evaluation, while its role in cases of inflammatory bowel disease-associated spondyloarthritis is still unclear. Web-based data from the cohort of the Sicilian Network for inflammatory bowel disease (SN-IBD) – a group composed by all Sicilian centres prescribing biologics – were extracted to perform a multicentre observational study on the effectiveness of VDZ on intestinal and articular symptoms after 10 and 22 weeks of treatment. From July 2016 to April 2017, 163 patients (84 with CD and 79 with UC) were included. At Week 10, a steroid-free remission was obtained in 71 patients (43.6%), and a clinical response in 37 (22.7%). At Week 22, 40.8% of patients were in steroid-free remission, and 14.1% showed a clinical response (Figure 1). At multiple logistic regression analysis, a longer duration of disease (OR 0.961, p = 0.047) and the presence of steroid dependence (OR 0.189, p = 0.033) were predictors of reduced rates of clinical benefit at Week 10, while a low serum level of C-reactive protein at baseline (OR 0.950, p = 0.031) predicted clinical benefit at Week 22. An improvement on articular symptoms was reported in 39.5% of patients with active spondyloarthritis at baseline after 10 weeks, and in 45.4% of patients at Week 22 (Figure 2). The only factor associated with articular response was the coexistence of clinical benefit on intestinal symptoms (at Week 10: OR 8.471, p = 0.05; at Week 22: OR 5.600, p = 0.08). In our large cohort of Sicilian IBD patients, VDZ showed good effectiveness after 10 and 22 weeks of treatment, particularly in those with limited inflammatory burden. A subset of patients reported improvement on articular symptoms, probably as a consequence of the concomitant control of gut inflammation.