Publication

In a Dutch real-life inflammatory bowel disease score cohort with 90% prior anti-tumour necrosis factor failure, vedolizumab showed a 25% remission rate: a retrospective multicentre study

Gabriëls, R. Y., de Graaf, A. P. J., Meijssen, M. A. C., Gotz, JM., Mensink, PBF., Russel, M., van Dullemen, H., ter Steege, R. W. F., Weersma, R. & Dijkstra, G., 2016.

Research output: Contribution to conferenceAbstractAcademic

Background
Vedolizumab is a humanised monoclonal antibody against α4β7-integrin capable of blocking the migration of several immune cells across endothelium expressing MAdCAM-1. This new class of biological drugs has shown efficacy in treating inflammatory bowel disease (IBD) in randomised clinical trials. Vedolizumab is registered since October 2014 in the Netherlands. Here, we describe the clinical experience in 3 centres using vedolizumab for ulcerative colitis (UC) and Crohn’s disease (CD).


Methods
We retrospectively analysed clinical activity and clinical response determined by a composite score based on a VAS scale for pain and fatigue, number of liquid stools, choice of treatment, patient’s ability to work or study, and the conclusion of the attending physician. Further laboratory parameters and the use of vedolizumab was studied.


Results
From October 2014 until November 2015, 48 patients with moderate/severe IBD (mean age 43, 39.6% male, 27; CD and 21 UC patients) were included; 90% had failed at least 1 tumour necrosis factor (TNF) antagonist before treatment. The average duration of disease before treatment with vedolizumab was 9.4 years (range 1–38 years). The average duration of vedolizumab treatment was 25.7 weeks (average 5.6 infusions administered). Concomitant medication included mesalazine (20%), MTX or Thiopurines (20%), Steroids (33%), and 27% was treated with vedolizumab as monotherapy. Further, 27 patients, 56 % (17 CD patients and 10 UC patients) responded to vedolizumab (average 6.8 doses; follow-up 32 weeks) 44% of these responders (7 CD patients and 5 UC patients) reached remission after average 7.2 infusions (41 weeks follow-up). In addition, 15 patients, 31% (7 CD patients, 8 UC patients) were primary non-responders. Moreover, 5 patients, 10% (2 CD patients, 3 UC patients) showed loss of response; 1 of them underwent surgery. In 1 CD patient (2%), vedolizumab was stopped after 1 infusion because of side effects (nasopharyngitis).


Conclusion
In this Dutch real-life IBD cohort with 90% prior anti-TNF failure, vedolizumab showed a 56% response and 25% remission rate without showing major adverse events.
Original languageEnglish
Publication statusPublished - 2016
Event11th Congress of European Crohn and Colitis Organization (ECCO) - RAI, Amsterdam, Netherlands
Duration: 16-Mar-201619-Mar-2016

Conference

Conference11th Congress of European Crohn and Colitis Organization (ECCO)
CountryNetherlands
CityAmsterdam
Period16/03/201619/03/2016

Event

11th Congress of European Crohn and Colitis Organization (ECCO)

16/03/201619/03/2016

Amsterdam, Netherlands

Event: Conference

View graph of relations

ID: 67123469