Long-term efficacy of vedolizumab therapy in patients with Crohn’s disease

Abstract

Introduction: Currently, the possibilities in the treatment of Crohn’s disease (CD) are expanding. Various classes of genetically engineered biological therapy are available for the treatment of inflammatory bowel diseases (IBD). Vedolizumab, having a selective nature of action, has a higher safety profile of the drug, which suggests lower immunogenicity and, as a consequence, long-term efficacy. Materials and methods: A retrospective study was conducted on the basis of the National Medical Research Centre of Coloproctology named after A. N. Ryzhikh, which included 54 patients treated with vedolizumab. In the course of the work, the survival of therapy was evaluated, as well as the influence of demographic characteristics, localization, phenotype of the disease and other factors on the effectiveness of therapy. Results: The study showed 86.0% (95% CI 72.8-93.1) survival of therapy for 15 months and 75.9% (95% CI 58.8-86.7) for two years. No statistically significant differences were obtained when assessing the effect of gender, comorbidity, lesion localization, disease phenotype, smoker status and the use of glucocorticosteroids during vedolizumab induction. During the analysis, it was revealed that significant factors affecting the effectiveness of therapy are the age of CD debut less than 21 years and the SES-CD index index more than 7, as well as previous therapy with the use of two or more anti-TNF drugs. Discussion: Despite the small sample size, the findings allow us to predict the effectiveness of therapy, which may affect survival.