Article Text
Abstract
Background Vedolizumab is a therapeutic alternative indicated in patients with moderate-severe inflammatory bowel disease (IBD) (ulcerative colitis (UC) and Crohn’s Disease (CD)) with loss of response or intolerance to first-line treatment.
Purpose To evaluate the effectiveness and safety of induction treatment with vedolizumab in patients diagnosed with IBD.
Material and methods Observational retrospective study was conducted from February 2016 to September 2017. Patients with IBD who had received treatment with vedolizumab were included. Variables collected were: demographic (age, sex), clinical (time from diagnosis to the start of treatment with vedolizumab, number of prior anti-TNFα), related to effectiveness (variation of corticosteroid doses, haemoglobin, c-reactive protein, faecal calprotectin and number of stools from week 0 to week 6) and related to safety (adverse events). Variables related to effectiveness were measured at week 0 and week 6. Student’s t-test (SPSS 20.0) was used to quantify the variation in the analytical parameters.
Results We included 19 patients (53% malea), with a mean age of 46 (SD: 16) years, treated with vedolizumab. Eleven of them presented the diagnosis of CU.
The mean number of months from diagnosis to start with vedolizumab was 83 (SD: 79). 15.8% were not treated with any anti-TNFα previously, 10.5% with infliximab, 68.4% with infliximab and adalimumab, and 5.3% with infliximab, adalimumab and golimumab. The reason to begin vedolizumab treatment was a previous loss of response to anti-TNF in 84.2% of patients.
Of the 14 patients being treated concomitantly with corticosteroids, the dose was reduced in 71.4% of them. There were no statistically significant differences in faecal calprotectin, haemoglobin, c-reactive protein levels (p>0.05) at week 6 compared to baseline level. 18.2% patients had a decrease in the number of stools.
Only two patients presented adverse events associated with the treatment (skin reactions).
Conclusion Vedolizumab has been shown to be effective and safe in our patients during the induction period, allowing a reduction in corticoid doses and the number of stools, improving the quality of life of our patients. However, there were not any differences in the analytical parameters.
References and/or Acknowledgements My gratitude to the general hospital Reina Sofia and the people who helped me to conduct the study
No conflict of interest