Clinical efficacy of vedolizumab for inflammatory bowel disease

Abstract

Objective To assess clinical efficacy of vedolizumab （VDZ） in the treatment of inflammatory bowel disease（IBD） and analyze whether VDZ combined with immunomodulator and/or corticosteroids can achieve better outcomes. Methods Twenty-nine patients with active IBD including 21 cases of ulcerative colitis （UC） and 8 cases of Crohn’s disease （CD） were recruited. They were assigned to receive VDZ （at a dose of 300 mg） intravenously at 0, 2, 6 weeks as induction therapy and every 8 or 4 weeks as maintenance therapy. The primary endpoint was clinical response at week 14/22, while the secondary endpoints were clinical remission and mucosal healing at week 54 （VDZ administration every 8 weeks） or week 30 （VDZ administration every 4 weeks）. Based on the concomitant medications, all patients were divided into the VDZ monotherapy and combination groups （VDZ combined with immunomodulator and/or corticosteroids）. The therapeutic effect was compared between two groups. Results Among UC patients,clinical response and endoscopic remission rates at week 14/22 were 81% （13/16） and 63% （10/16）, respectively. At week 54, clinical remission rate was 80% （4/5）and mucosal healing rate was 40% （2/5）. Among CD patients, clinical response rates at week 14/22 and week 30 were 75% （6/8） and 100% （1/1）, respectively. There was no significant difference in clinical response rate at week 14/22 between the VDZ monotherapy and combination groups. Conclusions VDZ is an effective biologic agent as induction and maintenance therapy for UC and CD. VDZ combined with immunomodulator and/or corticosteroids brings no additional benefit in the induction therapy. Therefore, VDZ monotherapy may be a better choice in clinical practice.

Keywords

• |vedolizumab|inflammatory bowel disease|clinical remission|concomitant medication|mucosal healing