Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/24863
Title: Vedolizumab for ulcerative colitis: Real world outcomes from a multicenter observational cohort of Australia and Oxford.
Austin Authors: Pulusu, Samba Siva Reddy;Srinivasan, Ashish ;Krishnaprasad, Krupa;Cheng, Daniel;Begun, Jakob;Keung, Charlotte;Van Langenberg, Daniel;Thin, Lena;Mogilevski, Tamara;De Cruz, Peter P ;Radford-Smith, Graham;Flanagan, Emma;Bell, Sally;Kashkooli, Soleiman;Sparrow, Miles;Ghaly, Simon;Bampton, Peter;Sawyer, Elise;Connor, Susan;Rizvi, Quart-Ul-Ain;Andrews, Jane M;Mahy, Gillian;Chivers, Paola;Travis, Simon;Lawrance, Ian Craig
Affiliation: Department of Gastroenterology, Flinders Medical Centre, Bedford Park 5042, South Australia, Australia
Department of Gastroenterology, St Vincent's Hospital, Darlinghurst 2010, New South Wales, Australia
Department of Gastroenterology, The Alfred Hospital, Melbourne 3004, Victoria, Australia
Department of Gastroenterology, Northern Health, Epping 3076, Victoria, Australia
Translational Gastroenterology Unit, NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford OX3 9DU, United Kingdom..
Department of Gastroenterology, St Vincent's Hospital, Fitzroy 3065, Victoria, Australia
Gastroenterology and Hepatology
Centre for Inflammatory Bowel Diseases, St John of God Hospital, Subiaco 6008, Western Australia, Australia
Institute for Health Research, University of Notre Dame, Fremantle 6160, Western Australia, Australia
Department of Gastroenterology, Townsville Hospital, Douglas 4814, Queensland, Australia
Department of Gastroenterology, Royal Adelaide Hospital & University of Adelaide, Adelaide 5000, South Australia, Australia
Department of Gastroenterology, Liverpool Hospital, Sydney 2170, New South Wales, Australia
Department of Gastroenterology, Mater Hospital, Brisbane 4101, Queensland, Australia
Inflammatory Bowel Disease Research Group, Queensland institute of Medical Research, Herston 4006, Queensland, Australia
Department of Gastroenterology, Fiona Stanley Hospital, Murdoch 6150, Western Australia, Australia
Department of Gastroenterology, Eastern Health, Box Hill 3128, Victoria, Australia
Department of Gastroenterology, Mater Hospital, South Brisbane 4101, Queensland, Australia
Issue Date: 14-Aug-2020
metadata.dc.date: 2020-08-14
Publication information: World Journal of Gastroenterology 2020; 26(30): 4428-4441
Abstract: Vedolizumab (VDZ), a humanised monoclonal antibody that selectively inhibits alpha4-beta7 integrins is approved for use in adult moderate to severe ulcerative colitis (UC) patients. To assess the efficacy and safety of VDZ in the real-world management of UC in a large multicenter cohort involving two countries and to identify predictors of achieving remission. A retrospective review of Australian and Oxford, United Kingdom data for UC patients. Clinical response at 3 mo, endoscopic remission at 6 mo and clinical remission at 3, 6 and 12 mo were assessed. Cox regression models and Kaplan Meier curves were performed to assess the time to remission, time to failure and the covariates influencing them. Safety outcomes were recorded. Three hundred and three UC patients from 14 centres in Australia and United Kingdom, [60% n = 182, anti-TNF naïve] were included. The clinical response was 79% at 3 mo with more Australian patients achieving clinical response compared to Oxford (83% vs 70% P = 0.01). Clinical remission for all patients was 56%, 62% and 60% at 3, 6 and 12 mo respectively. Anti-TNF naive patients were more likely to achieve remission than exposed patients at all the time points (3 mo 66% vs 40% P < 0.001, 6 mo 73% vs 46% P < 0.001, 12 mo 66% vs 51% P = 0.03). More Australian patients achieved endoscopic remission at 6 mo compared to Oxford (69% vs 43% P = 0.01). On multi-variate analysis, anti-TNF naïve patients were 1.8 (95%CI: 1.3-2.3) times more likely to achieve remission than anti-TNF exposed (P < 0.001). 32 patients (11%) had colectomy by 12 mo. VDZ was safe and effective with 60% of UC patients achieving clinical remission at 12 mo and prior anti-TNF exposure influenced this outcome.
URI: https://ahro.austin.org.au/austinjspui/handle/1/24863
DOI: 10.3748/wjg.v26.i30.4428
PubMed URL: 32874055
Type: Journal Article
Subjects: Outcomes
Ulcerative colitis
Vedolizumab
Appears in Collections:Journal articles

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