Vedolizumab in IBD-Lessons From Real-world Experience; A Systematic Review and Pooled Analysis

J Crohns Colitis. 2018 Jan 24;12(2):245-257. doi: 10.1093/ecco-jcc/jjx143.

Abstract

Background: Vedolizumab [VDZ] is an anti-integrin monoclonal antibody effective in ulcerative colitis [UC] and Crohn's disease [CD]. Several real-world experience [RWE] studies with VDZ have been published to date. The aim of this systematic review was to summarise the available real-life experience with VDZ.

Methods: We performed a systematic review of the available RWE studies of VDZ in CD and UC. We performed a pooled analysis of the available efficacy and safety data for induction and maintenance treatment in adult cohorts. A narrative review of VDZ use in special clinical settings was also performed.

Results: Nine studies including 1565 [571 UC, 994 CD] adult patients were identified. In CD, clinical response and remission were achieved in 54% (95% confidence interval [CI] 41-66%) and 22% [95% CI 13-35%] by Week 6 and in 49% [95% CI 37-51%] and 32% [95% CI 23-42%] by Week 14; at Week 52, 45% [95% CI 28-64%] and 32% [95% CI 12-62] of the patients responded, and were in clinical remission, respectively. In UC, clinical response and remission were achieved in 43% [95% CI 37-49] and 25% [95% CI 12-45] by Week 6, respectively, and in 51% [95% CI 43-61%]and 30% [95% CI 24-36%] by Week 14/22, respectively; at week 52, clinical response and remission were achieved in 48% and 39% of the patients, respectively. Adverse effects were mostly minor and occurred in 30.6% of the patients; infections were reported in 3.4% of the patients.

Conclusions: VDZ is efficacious in CD and UC and has a favourable safety profile in RWE studies.

Keywords: Crohn’s disease; ulcerative colitis; Vedolizumab.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Age Factors
  • Antibodies, Monoclonal, Humanized / adverse effects
  • Antibodies, Monoclonal, Humanized / therapeutic use*
  • C-Reactive Protein / metabolism
  • Colitis, Ulcerative / blood
  • Colitis, Ulcerative / drug therapy*
  • Colitis, Ulcerative / surgery
  • Crohn Disease / blood
  • Crohn Disease / drug therapy*
  • Crohn Disease / surgery
  • Drug Monitoring
  • Female
  • Gastrointestinal Agents / adverse effects
  • Gastrointestinal Agents / therapeutic use*
  • Humans
  • Male
  • Postoperative Complications / etiology
  • Pregnancy
  • Pregnancy Outcome
  • Remission Induction
  • Treatment Outcome

Substances

  • Antibodies, Monoclonal, Humanized
  • Gastrointestinal Agents
  • C-Reactive Protein
  • vedolizumab