- Vedolizumab (Entyvio) shows greater response in patients with Crohn's disease (CD) with early-stage disease (≤2 years duration) than those with late-stage disease (>2 years).
- The effect was absent in ulcerative colitis (UC).
Why this matters
- Consider prescribing vedolizumab earlier in the course of CD.
- Similar effect of disease duration seen with TNF inhibitors.
- Retrospective multicenter cohort of patients with CD (n=650) and UC (n=437) treated with vedolizumab in the VICTORY Consortium.
- Outcomes were clinical remission (complete remission of symptoms on clinical evaluation), corticosteroid-free remission (CSFR; remission after tapering off corticosteroids and no repeat corticosteroids within 4 weeks of tapering), and endoscopic remission (absence of ulcers or erosions by endoscopy).
- Funding: Takeda Pharmaceuticals USA, Inc.
- Early-stage CD (vs late-stage) is associated with greater likelihood of achieving these types of remission, after adjusting for disease-related factors including earlier exposure to TNF inhibitors:
- clinical remission (adjusted HR [aHR], 1.59; 95% CI, 1.02-2.49),
- CSFR (aHR, 3.39; 95% CI, 1.66-6.92), and
- endoscopic remission (aHR, 1.90; 95% CI, 1.06-3.39).
- No differences in early- vs late-stage disease response to vedolizumab in patients with UC.
- Retrospective, observational design.
- Lack of well-validated methods to study treatment remission.