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Vedolizumab: early experience and medium-term outcomes from two UK tertiary IBD centres
  1. Mark A Samaan1,
  2. Polychronis Pavlidis2,
  3. Emma Johnston1,
  4. Ben Warner1,
  5. Jonathan Digby-Bell1,
  6. Ioannis Koumoutsos1,
  7. Steven Fong1,
  8. Rimma Goldberg1,
  9. Kamal Patel1,
  10. Shraddha Gulati2,
  11. Lucy Medcalf2,
  12. Marlene Sastrillo1,
  13. Cordella Brown-Clarke1,
  14. Johanna Bidewell-Sullivan1,
  15. Katrina Forsyth1,
  16. Emma Lee1,
  17. Anna Stanton1,
  18. Julie Duncan1,
  19. Guy Chung-Faye2,
  20. Patrick Dubois2,
  21. Nick Powell1,
  22. Simon Anderson1,
  23. Jeremy Sanderson1,
  24. Bu'Hussain Hayee2,
  25. Peter M Irving1
  1. 1IBD Centre, Guy's & St Thomas’ NHS Foundation Trust, IBD Centre, London, UK
  2. 2IBD Service, King's College Hospital NHS Foundation Trust, London, UK
  1. Correspondence to Mark A Samaan, Guy's & St Thomas' NHS Foundation Trust, Department of Gastroenterology, First Floor College House, North Wing, St Thomas' Hospital, Westminster Bridge Road, London SE1 7EH, UK; markasamaan{at}gmail.com

Abstract

Objective To gain an understanding of the efficacy of vedolizumab in a ‘real-world’ setting.

Design Retrospective cohort study using prospectively maintained clinical records.

Setting Two UK tertiary inflammatory bowel disease (IBD) centres.

Patients Patients with IBD commenced on vedolizumab at Guy's & St Thomas' and King's College Hospitals during November 2014–November 2015.

Intervention Vedolizumab, a monoclonal antibody to α-4 β-7 integrins that selectively inhibit leucocyte migration into the gut.

Main outcome measures Clinical disease activity was assessed at baseline, weeks 14 and 30 using Harvey–Bradshaw Index (HBI) for Crohn's disease (CD) and Simple Clinical Colitis Activity Index (SCCAI) for ulcerative colitis (UC). Response was defined as HBI or SCCAI reduction ≥3. Remission was defined as HBI <5 or SCCAI <3. Continuous data are summarised as medians, followed by range.

Results Fifty patients were included: 27 CD, 20 UC and 3 IBD-U (included in the UC group for analysis). At baseline visit, the median HBI was 8 (1–16) and SCCAI was 6 (0–15). At week 14, these values had fallen to 5 (0–15) (p=0.117) and 4 (0–10) (p=0.005), respectively. Additionally, week 30 data were available for 19 patients (9 CD, 10 UC). The clinical disease activity scores at that point were HBI 2 (0–7) (p=0.039) and SCCAI 2 (0–10) (p=0.023). At baseline, 37 (74%) of the 50 patients had clinically active disease. Of the patients with active disease, 22 (59%) responded and 14 (38%) achieved remission at week 14.

Conclusions Our early experience with vedolizumab demonstrates a clear benefit in terms of disease control as well as a steroid-sparing effect in a cohort, which included patients with complex and previously refractory disease.

  • INFLAMMATORY BOWEL DISEASE
  • CROHN'S DISEASE
  • ULCERATIVE COLITIS

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