Shorter Disease Duration Is Associated With Higher Rates of Response to Vedolizumab in Patients With Crohn’s Disease But Not Ulcerative Colitis
2019
Background & Aims Patients with Crohn's disease (CD), but not ulcerative colitis (UC), of shorter duration have higher rates of response to tumor necrosis factor (TNF) antagonists than patients with longer disease duration. Little is known about the association between disease duration and response to other
biologic agents. We aimed to evaluate response of patients with CD or UC to
vedolizumab, stratified by disease duration. Methods We analyzed data from a retrospective, multicenter, consortium of patients with CD (n = 650) or UC (n = 437) treated with
vedolizumabfrom May 2014 through December 2016. Using time to event analyses, we compared rates of clinical remission, corticosteroid-free remission (CSFR), and endoscopic remission between patients with early-stage (≤2 years duration) and later-stage (>2 years) CD or UC. We used Cox proportional hazards models to identify factors associated with outcomes. Results Within 6 months initiation of treatment with
vedolizumab, significantly higher proportions of patients with early-stage CD, vs later-stage CD, achieved clinical remission (38% vs 23%), CSFR (43% vs 14%), and endoscopic remission (29% vs 13%) ( P Conclusions Patients with CD for 2 years or less are significantly more likely to achieve a complete response, CSFR, or endoscopic response to
vedolizumabthan patients with longer disease duration. Disease duration does not associate with response
vedolizumabin patients with UC.
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