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• W2978312129 abstract "Introduction: Vedolizumab (VDZ) was shown to effectively treat Crohn's disease (CD) and UC in clinical trials as both primary therapy and as salvage therapy for those who were refractory to anti-TNF medications. In practice, most patients did not initiate VDZ unless they had failed prior therapies. We sought to determine if age of IBD diagnosis or total amount of years with disease impacted VDZ response. Methods: Systematic chart review was conducted for patients with IBD treated at our institution with biologic therapy from 6/2009 - 11/2014. Those treated with VDZ were selected. Baseline characteristics were collected (age at diagnosis, years of disease, chronic steroid use, and prior immunomodulators or biologics). Pre and post VDZ Harvey Bradshaw Index (HBI), Partial Mayo Score (PMS), CRP, and ESR were collected. We defined response as change of > 3 points for HBI or PMS and remission as a total of HBI < 4 or a PMS < 3. We documented need for surgery or steroids while receiving VDZ. Results: Of 420 subjects prescribed biologics, 110 were prescribed VDZ and 70 started VDZ, receiving on average 6.4 doses. Only 4% (3/70) had never failed an anti-TNF, while 21.4% (15/70), 54.3% (38/70), and 20% (14/70) had failed one, two, and three anti-TNF, respectively. Average age of diagnosis was 27.5 (5-71). UC cohorts stratified by duration of disease had a trend toward significance to achieve clinical remission if there was > 8.8 years of disease compared to those with < 8.8 years of disease; 66.7% (8/12) vs 28.6% (4/14), respectively (p=0.11). This was not seen with regard to clinical response in the UC cohort 35.7% (5/14) for those with < 8.8 years compared to 50% (6/12) for those with > 8.8 years of disease (p=0.69). There was no significance when stratifying CD cohorts by duration of disease (with a cut off of 16.7 years) and comparing rates of clinical response or remission. UC and CD cohorts stratified by age at diagnosis (> 30 years vs < 30 years) showed no statistically significant difference in clinical response or remission. Changes in ESR or CRP and need for steroids or surgery once VDZ was started, did not reach statistical significance when stratified by age at diagnosis or duration of disease. Conclusion: Age of IBD diagnosis does not appear to impact response to vedolizumab, and should not be taken into consideration when prescribing the medication. Duration of disease may predict clinical remission for UC patients and further studies need to be performed." @default.
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• W2978312129 date "2015-10-01" @default.
• W2978312129 modified "2023-10-18" @default.
• W2978312129 title "Age of Inflammatory Bowel Disease at Diagnosis Does Not Affect Vedolizumab Response, but Total Years of Disease May Predict Clinical Remission in the Ulcerative Colitis Population" @default.
• W2978312129 doi "https://doi.org/10.14309/00000434-201510001-01997" @default.
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