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• W2977734547 abstract "Introduction: Vedolizumab (VDZ) was approved for the treatment of moderate to severe ulcerative colitis (UC) and Crohn's disease (CD) in May 2014. This case series reviews the occurrence of any post-procedure complications after initiation of VDZ therapy in 73 patients seen at a large tertiary referral center. Methods: Retrospective chart review of patients on VDZ therapy from June 2014 to May 2015. Data collected included age, sex, smoking status, disease phenotype, disease distribution, and all endoscopic and surgical procedures after initiation of VDZ. Body mass index (BMI), serum albumin, duration of VDZ therapy and pre-procedure timing of VDZ dosing was recorded for patients who had a procedure. Post-procedural complications were scored using the Accordion Classification scale, a validated tool to grade the severity of post-operative complications. Results: 73 patients were identified: 35 male/38 female, 45 CD/28 UC, 55/73 had never smoked, 4/73 were current smokers, and 14/73 were former smokers. 32/45 Crohn's patients had both large and small bowel disease. 21/45 Crohn's patients had perirectal involvement. Mean duration of VDZ therapy in the study period was 5.5 (SD ± 2.27) months in CD and 6.5 (SD ± 2.28) months in UC. 46 procedures occurred in 36 patients after initiation of VDZ therapy (Table 1). 5 procedures had associated complications, including spontaneous mucosal tearing, anastomotic leak with intra-abdominal abscess, and wound dehiscence. In these patients, the mean duration of VDZ therapy prior to procedure was 5 (SD ± 1.59) months, mean number of days between VDZ infusion and procedure was 29 (SD ± 19.59) days, mean BMI was 24 (SD ± 6.61) kg/m2 and mean albumin was 3.4 (SD ± 0.38) g/dL (Table 2).Table 1: Demographics of all VDZ therapy patientsTable 2: Characteristics of Patients with ComplicationsConclusion: VDZ affects leukocyte trafficking to the intestines and therefore has a theoretically increased risk of impaired intestinal mucosal and serosal wound healing due to a reduction in the inflammatory response needed to initiate the healing of these injuries. While initial phase III trials in UC and CD did not show a significantly increased risk of bowel perforation, an open-label trial is ongoing to better characterize the long-term safety of VDZ. This is the first case series review of non-study patients on VDZ therapy to evaluate the occurrence of these potential complications. Further studies are needed to better characterize if VDZ therapy has any impact on the occurrence and severity of post-procedural complications." @default.
• W2977734547 created "2019-10-10" @default.
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• W2977734547 date "2015-10-01" @default.
• W2977734547 modified "2023-09-27" @default.
• W2977734547 title "Vedolizumab Therapy in Crohnʼs Disease and Ulcerative Colitis: A Retrospective Review of Post-procedural Complications" @default.
• W2977734547 doi "https://doi.org/10.14309/00000434-201510001-01817" @default.
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