🫀 Vedolizumab: Real-world Performance in Very-Early-Onset IBD
🔥 Main in 3 points
- Vedolizumab and ustekinumab are effective as second-line or later therapies in children diagnosed with IBD before age 6 (VEO-IBD).
- At 1 year, steroid-free clinical remission with VDZ in VEO-IBD was 36%, with no discontinuations due to adverse events.
- Vedolizumab maintained persistence (continued use without discontinuation) of 46%, with favorable tolerability even in this difficult-to-treat population.
🧪 Context
Retrospective multicenter cohort (n=101) of Japanese VEO-IBD patients, evaluating SFCR and treatment persistence for IFX, ADL, UST, and VDZ as first- and subsequent-line therapies over ≥12 months; monogenic IBD excluded.
📍 Practical significance
Consider vedolizumab as an effective and well-tolerated option for young children with IBD not responding to TNF inhibitors, with persistence rates outpacing many alternatives and minimal safety concerns in this setting.
🔗 Source
PubMed
DOI
🫀 Vedolizumab in Real-World UC: Outstanding Persistence and Few Early Dropouts
🧪 What was studied
Retrospective population-based cohort from Australia (2019–2020) investigated real-world bDMARD initiation for Crohn's (n=522) and UC (n=390); examined discontinuation (non-response) rates at weeks 16 and 40 for various biologics, including vedolizumab.
📈 Key results
In UC patients, vedolizumab had:
- The lowest primary non-response at 16 weeks (5%) and secondary non-response by 40 weeks (8%), markedly lower than adalimumab or other agents.
- Suggests both strong early efficacy and exceptional maintenance/persistence compared to alternatives.
📍 What this changes in practice
In moderate-to-severe UC, vedolizumab stands out as a first-line advanced therapy due to its proven real-world persistence and low discontinuation rates, particularly valuable in managing refractory or complex UC.
🔗 Source
PubMed
DOI
🧪 Mesalazine: Drug Intolerance Risk Heightened with Vedolizumab Co-use
🩸 What was studied
Pharmacovigilance study using the Japanese JADER database examined signals and risk factors for mesalazine-related adverse events (AEs, n not specified).
📊 Numbers
- 15 of 25 pre-specified AEs signaled; 9 were early onset.
- Multivariate analysis identified concomitant use of vedolizumab, upadacitinib, budesonide, golimumab, and male sex as associated with higher odds of mesalazine intolerance (p < 0.01).
📍 Actions
Monitor for mesalazine intolerance, especially in males and with concomitant vedolizumab or other immune therapies. Early onset of intolerance is common; prompt recognition and adjustment may improve patient outcomes.
🔗 Source
PubMed
DOI
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