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Shorter Disease Duration Is Associated With Higher Rates of Response to Vedolizumab in Patients With Crohn’s Disease But Not Ulcerative Colitis
| Content Provider | Scilit |
|---|---|
| Author | Faleck, David M. Winters, Adam Chablaney, Shreya Shashi, Preeti Meserve, Joseph Weiss, Aaron Aniwan, Satimai Koliani-Pace, Jenna L. Kochhar, Gursimran Boland, Brigid S. Singh, Siddharth Hirten, Robert Shmidt, Eugenia Kesar, Varun Lasch, Karen Luo, Michelle Bohm, Matthew Varma, Sashidhar Fischer, Monika Hudesman, David Chang, Shannon Lukin, Dana Sultan, Keith Swaminath, Arun Gupta, Nitin Siegel, Corey A. Shen, Bo Sandborn, William J. Kane, Sunanda Loftus, Edward V. Sands, Bruce E. Colombel, Jean-Frederic Dulai, Parambir S. Ungaro, Ryan |
| Copyright Year | 2019 |
| Description | Journal: Clinical Gastroenterology and Hepatology Background & Aims Patients with Crohn's disease (CD), but not ulcerative colitis (UC), of shorter duration have higher rates of response to tumor necrosis factor (TNF) antagonists than patients with longer disease duration. Little is known about the association between disease duration and response to other biologic agents. We aimed to evaluate response of patients with CD or UC to vedolizumab, stratified by disease duration. Methods We analyzed data from a retrospective, multicenter, consortium of patients with CD (n = 650) or UC (n = 437) treated with vedolizumab from May 2014 through December 2016. Using time to event analyses, we compared rates of clinical remission, corticosteroid-free remission (CSFR), and endoscopic remission between patients with early-stage (≤2 years duration) and later-stage (>2 years) CD or UC. We used Cox proportional hazards models to identify factors associated with outcomes. Results Within 6 months initiation of treatment with vedolizumab, significantly higher proportions of patients with early-stage CD, vs later-stage CD, achieved clinical remission (38% vs 23%), CSFR (43% vs 14%), and endoscopic remission (29% vs 13%) (P < .05 for all comparisons). After adjusting for disease-related factors including previous exposure to TNF antagonists, patients with early-stage CD were significantly more likely than patients with later-stage CD to achieve clinical remission (adjusted hazard ratio [aHR], 1.59; 95% CI, 1.02–2.49), CSFR (aHR, 3.39; 95% CI, 1.66–6.92), and endoscopic remission (aHR, 1.90; 95% CI, 1.06–3.39). In contrast, disease duration was not a significant predictor of response among patients with UC. Conclusions Patients with CD for 2 years or less are significantly more likely to achieve a complete response, CSFR, or endoscopic response to vedolizumab than patients with longer disease duration. Disease duration does not associate with response vedolizumab in patients with UC. |
| Related Links | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7026826/pdf http://www.cghjournal.org/article/S1542356519300138/pdf |
| ISSN | 15423565 |
| e-ISSN | 15427714 |
| DOI | 10.1016/j.cgh.2018.12.040 |
| Journal | Clinical Gastroenterology and Hepatology |
| Issue Number | 12 |
| Volume Number | 17 |
| Language | English |
| Publisher | Elsevier BV |
| Publisher Date | 2019-01-06 |
| Access Restriction | Open |
| Subject Keyword | Journal: Clinical Gastroenterology and Hepatology Gastroenterology and Hepatology Inflammatory Bowel Disease Monoclonal Antibody Therapy Adjusted Hazard Ratio Crohn's Disease Confidence Interval Corticosteroid-free Remission Hazard Ratio Tumor Necrosis Factor Ulcerative Colitis |
| Content Type | Text |
| Resource Type | Article |
| Subject | Hepatology Gastroenterology |
