Long-term outcomes and predictors of vedolizumab persistence in ulcerative colitis

• Published in: Therapeutic advances in gastroenterology 2024-01, Vol.17, p.17562848241258372
• Main Authors: Gros, Beatriz, Ross, Hannah, Nwabueze, Maureen, Constantine-Cooke, Nathan, Derikx, Lauranne A A P, Lyons, Mathew, O'Hare, Claire, Noble, Colin, Arnott, Ian D, Jones, Gareth-Rhys, Lees, Charlie W, Plevris, Nikolas
• Format: Article
• Language: English
• Subjects: Original Research
• ISSN: 1756-283X; 1756-2848; 1756-2848
• DOI: 10.1177/17562848241258372

Long-term vedolizumab (VDZ) outcomes in real-world cohorts have been largely limited to 1-year follow-up, with few bio-naïve patients or objective markers of inflammation assessed. We aimed to assess factors affecting VDZ persistence including clinical, biochemical and faecal biomarker remission at 1, 3 and 5 years. We performed a retrospective, observational, cohort study. All adult inflammatory bowel disease (IBD) patients who had received VDZ induction for ulcerative colitis (UC)/IBD-unclassified (IBDU) were included. Baseline phenotype and follow-up data were collected a review of electronic medical records. We included 290 patients [UC  = 271 (93.4%), IBDU  = 19 (6.6%)] with a median time on VDZ of 27.6 months (interquartile range: 14.4-43.2). At the end of follow-up, a total of 157/290 (54.1%) patients remained on VDZ. The median time to discontinuation was 14.1 months (7.0-23.3). Previous exposure to ⩾1 advanced therapy, steroid use at baseline and disease extension (E3 and E2 E1) were independent predictors for worse VDZ persistence. Clinical remission (partial Mayo