Long-term effectiveness of vedolizumab in inflammatory bowel disease: a national study based on the Swedish National Quality Registry for Inflammatory Bowel Disease (SWIBREG)

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Long-term effectiveness of vedolizumab in inflammatory bowel disease : a national study based on the Swedish National Quality Registry for Inflammatory Bowel Disease (SWIBREG)

Eriksson, Carl, 1981- (författare): Örebro University,Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Department of Gastroenterology, Faculty of Medicine and Health, Örebro university, Örebro, Sweden,Orebro Univ, Dept Gastroenterol, Fac Med & Hlth, SE-70182 Orebro, Sweden.

Marsal, Jan (författare): Lund University,Lunds universitet,Medicin/akutsjukvård, Lund,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Gastro,Forskargrupper vid Lunds universitet,Medicine, Lund,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Lund University Research Groups,Skåne University Hospital

Bergemalm, Daniel, 1977- (författare): Örebro University,Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Department of Gastroenterology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden,Orebro Univ, Dept Gastroenterol, Fac Med & Hlth, SE-70182 Orebro, Sweden.

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Vigren, Lina (författare): Department of Internal Medicine, Ystad Hospital, Ystad, Sweden,Ystad Hosp, Dept Internal Med, Ystad, Sweden.

Björk, Jan (författare): Department of Medicine, Center for Digestive Diseases, Karolinska University Hospital, Karolinska Institutet Solna, Stockholm, Sweden,Karolinska Inst, Karolinska Univ Hosp, Dept Med, Ctr Digest Dis, Stockholm, Sweden.

Eberhardson, Michael (författare): Karolinska Institutet,Karolinska University Hospital

Karling, Pontus (författare): Karolinska Institutet,Umeå universitet,Medicin,Umea Univ, Dept Publ Hlth & Clin Med, Umea, Sweden.,Umeå University, Sweden

Söderman, Charlotte (författare): Karolinska Institutet

Myrelid, Pär (författare): Linköpings universitet,Avdelningen för Kirurgi, Ortopedi och Onkologi,Medicinska fakulteten,Region Östergötland, Kirurgiska kliniken US,Linköping University Hospital

Cao, Yang, 1972- (författare): Karolinska Institute,Karolinska Institutet,Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Department of Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden,Orebro Univ, Sch Med Sci, Dept Clin Epidemiol & Biostat, Orebro, Sweden.;Karolinska Inst, Dept Med Epidemiol & Biostat, Stockholm, Sweden.

Sjöberg, Daniel, 1974- (författare): Uppsala universitet,Centrum för klinisk forskning Dalarna,Uppsala University, Sweden

Thörn, Mari (författare): Uppsala universitet,Gastroenterologi/hepatologi,Uppsala University, Sweden

Karlén, Per (författare): Department of Internal Medicine, Danderyd Hospital, Stockholm, Sweden,Danderyd Hosp, Dept Internal Med, Stockholm, Sweden.

Hertervig, Erik (författare): Department of Gastroenterology, Skåne University Hospital, Lund, Sweden,Skane Univ Hosp, Dept Gastroenterol, Lund, Sweden.

Strid, Hans (författare): Department of Internal Medicine, Södra Älvsborgs Sjukhus, Borås, Sweden,Sodra Alvsborgs Sjukhus, Dept Internal Med, Boras, Sweden.

Ludvigsson, Jonas F., 1969- (författare): Karolinska Institutet,Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Pediatrics, Örebro University Hospital, Örebro, Sweden,Karolinska Inst, Dept Med Epidemiol & Biostat, Stockholm, Sweden.;Orebro Univ Hosp, Dept Pediat, Orebro, Sweden.

Almer, Sven (författare): Karolinska Institutet,Karolinska University Hospital

Halfvarson, Jonas, 1970- (författare): Örebro University,Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Department of Gastroenterology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden,Orebro Univ, Dept Gastroenterol, Fac Med & Hlth, SE-70182 Orebro, Sweden.

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2017-03-31
2017
Engelska.
Ingår i: Scandinavian Journal of Gastroenterology. - : Taylor & Francis. - 0036-5521 .- 1502-7708. ; 52:6-7, s. 722-729

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Tidskriftsartikel (refereegranskat)

Abstract Ämnesord

Stäng

Objectives: Clinical trials have demonstrated the efficacy of vedolizumab in inflammatory bowel disease (IBD). However, these findings may not reflect the clinical practice. Therefore, we aimed to describe a vedolizumab-treated patient population and assess long-term effectiveness.Materials and methods: Patients initiating vedolizumab between 1 June 2014 and 30 May 2015 were identified through the Swedish National Quality Registry for IBD. Prospectively collected data on treatment and disease activity were extracted. Clinical remission was defined as Patient Harvey Bradshaw index<5 in Crohn's disease (CD) and Patient Simple Clinical Colitis Activity index<3 in ulcerative colitis (UC).Results: Two-hundred forty-six patients (147CD, 92 UC and 7 IBD-Unclassified) were included. On study entry, 86% had failed TNF-antagonist and 48% of the CD patients had undergone1 surgical resection. After a median follow-up of 17 (IQR: 14-20) months, 142 (58%) patients remained on vedolizumab. In total, 54% of the CD- and 64% of the UC patients were in clinical remission at the end of follow-up, with the clinical activity decreasing (p<.0001 in both groups). Faecal-calprotectin decreased in CD (p<.0001) and in UC (p=.001), whereas CRP decreased in CD (p=.002) but not in UC (p=.11). Previous anti-TNF exposure (adjusted HR: 4.03; 95% CI: 0.96-16.75) and elevated CRP at baseline (adjusted HR: 2.22; 95% CI: 1.10-4.35) seemed to be associated with discontinuation because of lack of response. Female sex was associated with termination because of intolerance (adjusted HR: 2.75; 95% CI: 1.16-6.48).Conclusion: Vedolizumab-treated patients represent a treatment-refractory group. A long-term effect can be achieved, even beyond 1 year of treatment.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Gastroenterologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Gastroenterology and Hepatology (hsv//eng)

Nyckelord

Vedolizumab
clinical practice
inflammatory bowel disease
Crohn's disease
ulcerative colitis
clinical practice
Crohn’s disease
inflammatory bowel disease
ulcerative colitis
Vedolizumab

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Gastroenterologi

Artiklar i publikationen: Scandinavian Jou ...

Av lärosätet: Örebro universitet; Umeå universitet; Uppsala universitet; Linköpings universitet; Karolinska Institutet; Lunds universitet

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