Published in:
01-06-2017 | Original Article
Predictors of Clinical Response and Remission at 1 Year Among a Multicenter Cohort of Patients with Inflammatory Bowel Disease Treated with Vedolizumab
Published in: Digestive Diseases and Sciences | Issue 6/2017
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Background
Vedolizumab (VDZ) has demonstrated long-term efficacy in Crohn’s disease (CD) and ulcerative colitis (UC) in phase III trials.
Aims
Our aim was to evaluate the efficacy of VDZ at week 54 in inflammatory bowel disease (IBD) in a multicenter cohort of patients.
Methods
Adult patients completing induction therapy with VDZ were eligible for this study. Clinical response and remission was assessed using the Harvey–Bradshaw Index (HBI) for CD, the Simple Clinical Colitis Activity Index for UC and physician assessment.
Results
Among 136 total patients (96 CD and 40 UC), 76 (56%) demonstrated clinical response or remission at week 54. In univariate analysis, for patients with CD concomitant initiation of immunomodulator therapy (2.71, 95% CI 1.11–6.57), the addition of an immunomodulator (OR 11.49, 3.16–41.75) and CRP < 3 (4.92, 95% CI 1.99–12.15) was associated with increased odds of clinical response or remission at week 54. For UC patients, hospitalization after VDZ induction was associated with decreased odds of response or remission at week 54 (OR 0.22, 95% CI 0.05–0.88). On multivariate analysis in CD, addition of an immunomodulator (OR 8.33, 95% CI 2.15–32.26) remained significant predictors of clinical response or remission at week 54.
Conclusions
Among a multicenter cohort of patients with IBD demonstrating primary response to VDZ, the addition of combination therapy with an immunomodulator is a significant predictor of clinical response or remission at week 54 in patients with CD.