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• W3094490814 abstract "INTRODUCTION: There is limited data available on the utility of drug monitoring with vedolizumab (VDZ) in patients with inflammatory bowel disease (IBD). The aim of our study was to determine if there is an association of VDZ drug levels withinflammatory markers, clinical and endoscopic scoring. METHODS: We collected data on IBD patients treated with VDZ from 2015 to 2020 who had VDZ trough levels drawn on maintenance therapy. Demographic data was collected including age, gender, IBD subtype, medications, disease location and duration, and BMI. In addition, clinical scoring, endoscopic data, and laboratory markers (albumin, Hg, ferritin, iron, PLT, ESR, CRP and vitamin D) were collected at baseline (prior to starting VDZ therapy) and at follow up (after at least two months on VDZ therapy). Low drug levels were defined as VDZ trough level less than 20 µg/mL. RESULTS: We identified 72 patients with a mean age of 41.9 years and 70.8% female. Of the 90 total trough levels drawn, 57.7% were low. Among patients on Q8 week dosing, 41/67 (61%) patients had low troughs. After dosing frequency increase to Q4 weeks all patients had improvement in VDZ levels, however, 11/36 (32%) remained under 20µg/mL. Higher VDZ levels on Q8 week dosing were associated with higher albumin levels P = 0.01. Higher VDZ levels on Q4 week dosing were associated with higher albumin P = 0.02, and lower ESR P = 0.04. Patients with higher VDZ levels on Q4 week dosing were more likely to have mild disease or remission endoscopically P = 0.01. Initiation of a second biologic in addition to VDZ was required in 14% of patients, and 8% discontinued VDZ and were switched to an alternative biologic. No significant association was found between VDZ levels and clinical scoring, BMI, hemoglobin, vitamin D, or platelet levels on either Q8 or Q4 week dosing. CONCLUSION: Our data suggests that higher trough vedolizumab levels were associated with mild disease or endoscopic remission, and lower levels were seen in patients with hypoalbuminemia and higher inflammatory disease burden, but not associated with clinical scoring and BMI. Patients who continue to have low VDZ trough levels despite Q4 week dosing may require a change in therapy.Table 1.: Baseline Characteristics of sample populationTable 2.: Characteristics associated with VDZ drug level" @default.
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• W3094490814 date "2020-10-01" @default.
• W3094490814 modified "2023-09-27" @default.
• W3094490814 title "S0843 Therapeutic Drug Monitoring in Inflammatory Bowel Disease Patients on Vedolizumab" @default.
• W3094490814 doi "https://doi.org/10.14309/01.ajg.0000705420.65162.c3" @default.
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