Biologic Associated With Higher UC Remission Rates

A recent study found that vedolizumab (Entyvio) was associated with higher rates of clinical remission compared with tumor necrosis factor (TNF)-antagonist therapies among patients with ulcerative colitis (UC).

In the study, the researchers examined data from a multicenter, US-based consortium that included 646 participants with UC who were treated with either vedolizumab or a TNF-antagonist therapy. A total of 334 participants were matched by age, sex, prior US-related hospitalization in the previous year, disease extent, disease severity, steroid refractoriness or dependence, and prior TNF-antagonist failure. The Physical Global Assessment was used to categorize treatment response and Cox proportional hazard models were used to compare cumulative rates of clinical remission, steroid-free remission, and endoscopic healing.
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After the researchers adjusted for concomitant steroid use, concomitant immunomodulator use, and the number of previously prescribed TNF-antagonists, they found that participants treated with vedolizumab had statistically significant higher 12-month cumulative rates of clinical remission compared with those not treated with vedolizumab (54% vs 37%, respectively), as well as higher rates of endoscopic healing (50% vs 42%, respectively). While cumulative 12-month rates for steroid-free remission where higher among participants treated with vedolizumab, these findings were not statistically significant (49% vs 38%, respectively). In addition, cumulative rates of clinical remission, endoscopic healing, and steroid-free remission were consistent when stratified by disease extent and prior TNF-antagonist exposure.

“After accounting for measurable disease and patient-specific characteristics that may impact biologic effectiveness, we observed that vedolizumab-treated UC participants had significantly higher 12-month cumulative rates of clinical remission and endoscopic healing, and numerically higher steroid-free remission rates, when compared to TNF-antagonist–treated participants,” the researchers concluded. “Randomized controlled trial data are needed to confirm these findings.”

Reference

Faleck D, Shashi P, Meserve J, et al. Comparative effectiveness of vedolizumab and tumor necrosis factor-antagonist therapy in ulcerative colitis: a multicenter consortium propensity score-matched analysis. Presented at: Digestive Disease Week; June 2-5, 2018; Washington, DC. Abstract 328.