Details

Autor(en) / Beteiligte

• Attauabi, Mohamed
• Höglund, Camilla
• Fassov, Janne
• Pedersen, Kenneth Bo
• Hansen, Heidi Bansholm
• Wildt, Signe
• Jensen, Michael Dam
• Neumann, Anders
• Lind, Cecilie
• Jacobsen, Henrik Albaek
• Popa, Ana-Maria
• Kjeldsen, Jens
• Pedersen, Natalia
• Molazahi, Akbar
• Haderslev, Kent
• Aalykke, Claus
• Knudsen, Torben
• Cebula, Wojciech
• Munkholm, Pia
• Bendtsen, Flemming
• Seidelin, Jakob Benedict
• Burisch, Johan

Titel

Vedolizumab as first-line biological therapy in elderly patients and those with contraindications for anti-TNF therapy: a real-world, nationwide cohort of patients with inflammatory bowel diseases

Ist Teil von

• Scandinavian journal of gastroenterology, 2021-09, Vol.56 (9), p.1040-1048

Ort / Verlag

England: Taylor & Francis

Erscheinungsjahr

2021

Quelle

MEDLINE

Beschreibungen/Notizen

• Data from real-life populations about vedolizumab as first-line biological therapy for ulcerative colitis (UC) and Crohn's disease (CD) are emerging. To investigate the efficacy and safety of vedolizumab in bio-naïve patients with UC and CD. A Danish nationwide cohort study was conducted between November 2014 and November 2019. Primary outcomes were clinical remission, steroid-free clinical remission, and sustained clinical remission from weeks 14 through 52. The study included 56 patients (UC:31, CD:25) who initiated treatment with vedolizumab mainly because of contraindications to anti-TNFs, of whom 54.8 and 24.0%, respectively received systemic steroids at the initiation. Rates of clinical remission at weeks 6, 14, and 52 were 32.0, 48.0, and 40.0%, respectively, in UC, and 36.8, 36.8, and 47.4% in CD. Steroid-free clinical remission at week 52 was achieved among 36.0 and 47.4% of UC and CD patients, while sustained clinical remission was achieved in 32.0 and 36.8%. Lack of remission was associated with being female (68.8 vs. 11.1%, p = .01) in UC and non-structuring, non-penetrating behavior in CD (90.0 vs. 44.4%, p = .03); however, this was not confirmed in multivariate analysis. Discontinuation due to primary non-response occurred in 20.0 and 5.3% of UC and CD patients, respectively, while rates of secondary loss of response were 12.0 and 5.3% after 52 weeks of follow-up. Vedolizumab was well-tolerated as only one UC patient experienced a serious adverse event. Vedolizumab is effective in the achievement of short-term, long-term, and steroid-free clinical remission in bio-naïve UC and CD patients.