Vedolizumab for ulcerative colitis: Real world outcomes from a multicenter observational cohort of Australia and Oxford

作     者：Samba Siva Reddy Pulusu Ashish Srinivasan Krupa Krishnaprasad Daniel Cheng Jakob Begun CharlotteKeung Daniel Van Langenberg Lena Thin Tamara Mogilevski Peter De Cruz Graham Radford-Smith Emma Flanagan Sally Bell Soleiman Kashkooli Miles Sparrow Simon Ghaly Peter Bampton Elise Sawyer Susan Connor Quart-ul-ain Rizvi Jane M Andrews Gillian Mahy Paola Chivers Simon Travis Ian Craig Lawrance 

作者机构：Centre for Inflammatory Bowel DiseasesSt John of God HospitalSubiaco 6008Western AustraliaAustralia Translational Gastroenterology UnitNIHR Oxford Biomedical Research CentreOxford University Hospitals NHS Foundation TrustJohn Radcliffe HospitalOxford OX39DUUnited Kingdom Inflammatory Bowel Disease Research GroupQueensland institute of Medical ResearchHerston 4006QueenslandAustralia Department of GastroenterologyMater HospitalBrisbane 4101QueenslandAustralia Department of GastroenterologyMater HospitalSouth Brisbane 4101QueenslandAustralia of GastroenterologyEastern HealthBox Hill 3128VictoriaAustralia Department of GastroenterologyFiona Stanley HospitalMurdoch 6150Western AustraliaAustralia Department of GastroenterologyAustin HealthHeidelberg 3084VictoriaAustralia Department of GastroenterologySt Vincent’s HospitalFitzroy 3065VictoriaAustralia Department of GastroenterologyNorthern HealthEpping 3076VictoriaAustralia Department of GastroenterologyThe Alfred HospitalMelbourne 3004VictoriaAustralia Department of GastroenterologySt Vincent’s HospitalDarlinghurst 2010New South WalesAustralia Department of GastroenterologyFlinders Medical CentreBedford Park 5042South AustraliaAustralia Department of GastroenterologyLiverpool HospitalSydney 2170New South WalesAustralia Department of GastroenterologyRoyal Adelaide Hospital&University of AdelaideAdelaide 5000South AustraliaAustralia Department of GastroenterologyTownsville HospitalDouglas 4814QueenslandAustralia Institute for Health ResearchUniversity of Notre DameFremantle 6160Western AustraliaAustralia School of Medicine and PharmacologyUniversity of Western AustraliaCrawley 6009Western AustraliaAustralia 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2020年第26卷第30期

页      面：4428-4441页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：Vedolizumab Ulcerative colitis Outcomes 

摘      要：BACKGROUND Vedolizumab(VDZ),a humanised monoclonal antibody that selectively inhibits alpha4-beta7 integrins is approved for use in adult moderate to severe ulcerative colitis(UC)*** To assess the efficacy and safety of VDZ in the real-world management of UC in a large multicenter cohort involving two countries and to identify predictors of achieving *** A retrospective review of Australian and Oxford,United Kingdom data for UC *** response at 3 mo,endoscopic remission at 6 mo and clinical remission at 3,6 and 12 mo were *** regression models and Kaplan Meier curves were performed to assess the time to remission,time to failure and the covariates influencing *** outcomes were *** Three hundred and three UC patients from 14 centres in Australia and United Kingdom,[60%n=182,anti-TNF naïve]were *** clinical response was 79%at 3 mo with more Australian patients achieving clinical response compared to Oxford(83%vs 70%P=0.01).Clinical remission for all patients was 56%,62%and 60%at 3,6 and 12 mo ***-TNF naive patients were more likely to achieve remission than exposed patients at all the time points(3 mo 66%vs 40%P0.001,6 mo 73%vs 46%P0.001,12 mo 66%vs 51%P=0.03).More Australian patients achieved endoscopic remission at 6 mo compared to Oxford(69%vs 43%P=0.01).On multi-variate analysis,anti-TNF naïve patients were 1.8(95%CI:1.3-2.3)times more likely to achieve remission than anti-TNF exposed(P0.001).32 patients(11%)had colectomy by 12 *** VDZ was safe and effective with 60%of UC patients achieving clinical remission at 12 mo and prior anti-TNF exposure influenced this outcome.