P502 Ulcerative colitis patients on vedolizumab lacking response at induction phase continue to improve over the first 6 months of treatment
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Notice bibliographique
Résumé
Background: Vedolizumab, a gut-selective anti-integrin inhibitor, is a biologic agent indicated for ulcerative colitis (UC) treatment. We retrospectively assessed the real-world efficacy and safety of vedolizumab as induction and maintenance therapy in UC patients. Methods: Adult UC patients followed at a tertiary IBD center and treated with vedolizumab were included. All patients received infusions at 0, 2, and 6 weeks and then every 8 weeks. Six-month cumulative rates of clinical remission (CR, partial Mayo score≤2) and steroid-free clinical remission (SFCR) were assessed with Kaplan-Meier survival analyses. Univariate and multivariable Cox proportional hazard (PH) analyses were performed to identify among baseline variables independent predictors of clinical remission. Hospitalizations, surgeries and adverse events were recorded. Results: Fifty-seven patients were analyzed (Table 1). At 2 months, CR and SFCR were 37% and 30%. At 6 months, the cumulative rates of CR and SFCR were 49% and 44% (Table 1, Fig. 1). Among patients who were not in CR after 3 infusions (n=36) the probability of remission with continuation of vedolizumab was 25% (9/36) at 6 months. Pairwise analyses showed significant improvement in median partial Mayo scores and median CRP levels over the 6-month period compared to baseline (Fig. 1). Cox PH analysis revealed a 3-fold increase in the probability of clinical remission at 6 months among patients with baseline CRP levels less than 5mg/L (univariate analysis, hazard ratio [HR]: 2.55, 95% CI: 1.17–5.57, p=0.019; multivariate analysis, HR: 2.72, 95% CI: 1.24–5.97, p=0.012) and mild baseline disease (univariate analysis, HR: 2.48, 95% CI: 1.2–5.54, p=0.026; multivariate analysis, HR: 2.86, 95% CI: 1.27–6.44, p=0.011) compared with those who did not (Fig. 1). Cumulative rates of colectomy were 5%, 9%, and 14% at 2, 4 and 6 months respectively. The most common side effect was headache. Figure 1. Clinical remission rates in UC patients on conitnuous vedolizumab for 6 months. Conclusions: In our study, 35% of UC patients, most of whom were unresponsive to anti-TNFs, achieved CR after induction and 50% were in CR at six months with vedolizumab maintenance treatment. We did not observe severe adverse events. Our data would indicate that a significant proportion of patients who had not achieved response at 2 months may go on to achieve CR by 6 months of continued therapy.
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Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découle