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• W2922084433 abstract "Introduction: Numerous studies have reported real-world mucosal healing with vedolizumab (VDZ), a gut-selective monoclonal anti-a4β7-integrin antibody approved for the treatment of adult patients (pts) with moderately to severely active Crohn's disease (CD). Mucosal healing is an important therapeutic goal associated with improved clinical outcomes in CD. A review and meta-analysis of published realworld mucosal healing rates with VDZ in CD was conducted. Methods: MEDLINE-, Cochrane-, and Embase-indexed publications and conference abstracts (n≥10) were searched from May 1, 2014, to June 4, 2018, for studies reporting real-world VDZ mucosal healing and/or endoscopic improvement rates. Reports for pts < 18 y old and off-label VDZ use were excluded. A meta-analysis was conducted (DerSimonian-Laird random-effects method) to obtain a weighted mean (95% confidence interval) of mucosal healing. If multiple reports were from the same cohort, the most recent cohort with the most pts was selected for the meta-analysis. Studies conducted in biologic-naive CD pts were evaluated separately and not included in the meta-analysis. Results: A total of 26 studies were identified, including 2 studies in biologic-naive CD patients (16, mucosal healing; 3, endoscopic improvement; 7, both). The median age of pts ranged from 34 to 49 y; median disease duration, 2-16 y; prior anti-tumor necrosis factor alpha exposure, 55%-99% (24 studies). The most common definition of mucosal healing (13 studies) was the absence of all ulcers and/or erosions, and the most common definition of endoscopic improvement (7 studies) was reduction in the Simple Endoscopic Score-CD of > 50%. Mucosal healing rates ranged from 14%-41% (7 studies) at 6 months (mo) and from 6%-65% (6 studies) at 12 mo. Pooled mucosal healing rates were 26% at 6 mo (n =1,020) and 37% at 12 mo (n =576) (Figure 1). In biologic-naive CD pts (2 studies), mucosal healing rates were 45% at 6 mo (n =11), 63% at 6 mo (n=8), and 100% at 12 mo (n =2). Four studies reported endoscopic improvement rates: 6 mo, range 25%-40% (3 studies); 12 mo, 38% (1 study).716 Figure 1 No Caption available.Conclusion: More than one-quarter of CD pts at 6 mo and over one-third at 12 mo achieved mucosal healing with VDZ in the real-world, despite utilization in largely biologic-refractory pts. Higher mucosal healing rates were observed in pts naive to prior biologic therapy. These data support the effectiveness of VDZ in inducing mucosal healing in CD in real-world clinical practice." @default.
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• W2922084433 date "2018-10-01" @default.
• W2922084433 modified "2023-09-27" @default.
• W2922084433 title "Real World Mucosal Healing With Vedolizumab in Crohnʼs Disease: A Systematic Review and Meta-Analysis" @default.
• W2922084433 doi "https://doi.org/10.14309/00000434-201810001-00716" @default.
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