Vedolizumab is effective and safe in real-life treatment of inflammatory bowel diseases outpatients: A multicenter, observational study in primary inflammatory bowel disease centers.


Journal

European journal of internal medicine
ISSN: 1879-0828
Titre abrégé: Eur J Intern Med
Pays: Netherlands
ID NLM: 9003220

Informations de publication

Date de publication:
Aug 2019
Historique:
received: 19 03 2019
revised: 07 06 2019
accepted: 10 06 2019
pubmed: 19 6 2019
medline: 2 10 2020
entrez: 19 6 2019
Statut: ppublish

Résumé

Italian data currently available in managing ulcerative colitis (UC) and Crohn's disease (CD) patients with vedolizumab (VDZ) are coming just from secondary and tertiary centers. The present study aimed to assess the real-life efficacy and safety of VDZ to achieve remission in inflammatory bowel diseases (IBD) outpatients in primary gastroenterology centers. Clinical activity was scored according to the Mayo score in UC and to the Harvey-Bradshaw Index (HBI) in CD. The primary endpoints were the achievement of clinical remission and safety. Secondary endpoints were clinical response to treatment, achievement of mucosal healing (MH), and steroid discontinuation. One hundred and thirty-six pts. were enrolled (91 UC and 45 CD pts). During an 18-month median follow-up, clinical remission was present in 63 (46.3%) pts.: in particular, it occurred in 48 (52.7%) patients in UC group and in 15 (33.3%) patients in CD group (p = 0.003). more in UC group. Fecal calprotectin ≥400 μg/g and presence of comorbidities were factors significantly related to the failure of remission in UC and CD, respectively. Ten (7.3%) cases of adverse events were recorded (2 required suspension of treatment). Clinical response was present in 105 (72.2%) pts.: 71 (78.0%) in UC and 34 (75.5%) in CD group. MH occurred in 47 (62.7%) UC and in 9 (50.0%) CD patients. Steroids discontinuation occurred in 92 (67.6%) pts.; 61 (67.0%) UC and 31 (68.9%) CD pts. VDZ is effective and safe in IBD outpatients, especially in UC patients.

Sections du résumé

BACKGROUND BACKGROUND
Italian data currently available in managing ulcerative colitis (UC) and Crohn's disease (CD) patients with vedolizumab (VDZ) are coming just from secondary and tertiary centers. The present study aimed to assess the real-life efficacy and safety of VDZ to achieve remission in inflammatory bowel diseases (IBD) outpatients in primary gastroenterology centers.
METHODS METHODS
Clinical activity was scored according to the Mayo score in UC and to the Harvey-Bradshaw Index (HBI) in CD. The primary endpoints were the achievement of clinical remission and safety. Secondary endpoints were clinical response to treatment, achievement of mucosal healing (MH), and steroid discontinuation.
RESULTS RESULTS
One hundred and thirty-six pts. were enrolled (91 UC and 45 CD pts). During an 18-month median follow-up, clinical remission was present in 63 (46.3%) pts.: in particular, it occurred in 48 (52.7%) patients in UC group and in 15 (33.3%) patients in CD group (p = 0.003). more in UC group. Fecal calprotectin ≥400 μg/g and presence of comorbidities were factors significantly related to the failure of remission in UC and CD, respectively. Ten (7.3%) cases of adverse events were recorded (2 required suspension of treatment). Clinical response was present in 105 (72.2%) pts.: 71 (78.0%) in UC and 34 (75.5%) in CD group. MH occurred in 47 (62.7%) UC and in 9 (50.0%) CD patients. Steroids discontinuation occurred in 92 (67.6%) pts.; 61 (67.0%) UC and 31 (68.9%) CD pts.
CONCLUSION CONCLUSIONS
VDZ is effective and safe in IBD outpatients, especially in UC patients.

Identifiants

pubmed: 31208827
pii: S0953-6205(19)30188-8
doi: 10.1016/j.ejim.2019.06.006
pii:
doi:

Substances chimiques

Antibodies, Monoclonal, Humanized 0
Leukocyte L1 Antigen Complex 0
C-Reactive Protein 9007-41-4
vedolizumab 9RV78Q2002

Types de publication

Journal Article Multicenter Study Observational Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

85-91

Informations de copyright

Copyright © 2019 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

Auteurs

Antonio Tursi (A)

Territorial Gastroenterology Service, ASL BAT, Andria, Italy. Electronic address: antotursi@tiscali.it.

Giammarco Mocci (G)

Division of Gastroenterology, "Brotzu" Hospital, Cagliari, Italy.

Roberto Faggiani (R)

Division of Gastroenterology, "Belcolle" Hospital, Viterbo, Italy.

Leonardo Allegretta (L)

Division of Gastroenterology, "Santa Caterina Novella" Hospital, Galatina (LE), Italy.

Nicola Della Valle (ND)

Division of Gastroenterology, A.O. "Ospedali Riuniti", Foggia, Italy.

Antonio de Medici (A)

Territorial Gastroenterology Service, PST Catanzaro Lido, Catanzaro, Italy.

Giacomo Forti (G)

Division of Digestive Endoscopy, "S. Maria Goretti" Hospital, Latina, Italy.

Marilisa Franceschi (M)

Digestive Endoscopy Unit, ULSS7 Pedemontana, Santorso (VI), Italy.

Antonio Ferronato (A)

Digestive Endoscopy Unit, ULSS7 Pedemontana, Santorso (VI), Italy.

Sara Gallina (S)

Division of Gastroenterology, "Belcolle" Hospital, Viterbo, Italy.

Giuseppina Grasso (G)

Division of Gastroenterology, "Santa Caterina Novella" Hospital, Galatina (LE), Italy.

Tiziana Larussa (T)

Department of Health Science, University of Catanzaro, Catanzaro, Italy.

Francesco Luzza (F)

Department of Health Science, University of Catanzaro, Catanzaro, Italy.

Roberto Lorenzetti (R)

Division of Gastroenterology, "Nuovo Regina Margherita" Territorial Hospital, Roma, Italy.

Antonio Penna (A)

Division of Gastroenterology, "S. Paolo" Hospital, Bari, Italy.

Stefano Rodino' (S)

Division of Gastroenterology, "Ciaccio-Pugliese" Hospital, Catanzaro, - Italy.

Ladislava Sebkova (L)

Division of Gastroenterology, "Ciaccio-Pugliese" Hospital, Catanzaro, - Italy.

Angelo Lauria (A)

Division of Gastroenterology, A.O. "Bianchi-Melacrino-Morelli", Reggio Calabria, Italy.

Simona Piergallini (S)

Division of Gastroenterology, IBD Unit, "A. Murri" Hospital, Fermo, Italy.

Giuseppe Pranzo (G)

Ambulatory for IBD Treatment, "Valle D'Itria" Hospital, Martina Franca (TA), Italy.

Stefano Scorza (S)

Division of Gastroenterology, "Santa Caterina Novella" Hospital, Galatina (LE), Italy.

Costantino Zampaletta (C)

Division of Gastroenterology, "Belcolle" Hospital, Viterbo, Italy.

Marcello Picchio (M)

Division of General Surgery, "P. Colombo" Hospital, ASL Roma 6, Velletri, Roma, Italy.

Walter Elisei (W)

Division of Gastroenterology, ASL Roma 6, Albano Laziale, Roma, Italy.

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