Vedolizumab induction therapy for inflammatory bowel disease in clinical practice – a nationwide consecutive German cohort study

Abstract

SUMMARY BackgroundVedolizumab (VDZ) is a humanised monoclonal IgG1 antibody targeting a 4 b 7 integrin.

Ustekinumab in Crohn’s disease: evidence to date and place in therapy

“…Thirteen patients had perianal disease, of which 69.2% achieved clinical response. Endoscopic improvement was reported in 76.9% (10/13) and two patients achieved mucosal healing similar to the mucosal healing rates reported in the CERTIFI trial [Baumgart et al 2016;Kopylov et al 2014]. A retrospective observational study that was recently published by the Groupe d'Etude Thérapeutique des Affections Inflammatoires du tube Digestif (GETAID) reported the results for 122 patients with active CD who lost response to anti-TNF therapy and received subcutaneous ustekinumab.…”

“…Importantly, the efficacy of vedolizumab for treatment of anti-TNF-resistant CD appears to be quite modest [Sandborn et al 2013, Côté-Daigneault et al 2015. In real-world cohorts of patients with CD or ulcerative colitis (UC) whose disease has failed to respond to previous anti-TNF therapy, approximately one third of patients achieved steroid-free clinical remission after 14 weeks of treatment with vedolizumab [Amiot et al 2016;Baumgart et al 2016]. This emphasizes the need for novel and effective agents.…”

Real-World Outcomes of Vedolizumab Therapy in Ulcerative Colitis and Crohn’s Disease at a Tertiary Referral Center

“…In a previous prospective German cohort study [8], the success of vedolizumab was evaluated after 14 weeks of treatment. At week 14, the authors of that study found a clinical response rate of 60.8% for Crohn's disease patients and 57.4% for ulcerative colitis patients, while we found a response rate of 61% for Crohn's disease patients and 52% for ulcerative colitis patients at week 30.…”

“…The median time until achievement of clinical remission was 25 weeks [7]. A German prospective study assessing the efficacy of vedolizumab induction therapy showed clinical remission at week 14 in 23.7% of the patients with Crohn's disease and 23.5% of the patients with ulcerative colitis [8]. In this patient group, clinical remission was achieved after 54 weeks in 21% of the patients with Crohn's disease and 25% of the patients with ulcerative colitis [9].…”

Immunephenotype Predicts Response to Vedolizumab: Integrating Clinical and Biochemical Biomarkers in the Treatment of Inflammatory Bowel Diseases

“…Nevertheless, similar to anti-TNFα agents, a significant proportion of patients (≈ 40%) failed to reach or to maintain remission in response to vedolizumab. In real-word cohorts, the primary response rate to vedolizumab is effectively similar in UC and CD patients, 40-60% of patients [5,6]. Lack of response or need for dose optimization occurs in 40-60% of IBD patients during the maintenance phase [7,8].…”