Abstract | BACKGROUND AND AIMS: METHODS: This was a retrospective, multicenter cohort study at 5 academic referral centers in the United States. Adult patients with endoscopic inflammation of the pouch who received vedolizumab were included. The primary outcome was clinical response at any time point. Secondary outcomes included clinical remission, endoscopic response, and remission. Univariate analysis and multivariate analysis were performed for the effect of the following variables on clinical response: fistula, onset of pouchitis less than 1 year after IPAA, younger than 35 years old, gender, previous tumor necrosis factor inhibitor-alpha use, and BMI >30. RESULTS: Eighty-three patients were treated with vedolizumab for inflammation of the pouch between January 2014 and October 2017. Median follow-up was 1.3 years (interquartile range 0.7-2.1). The proportion of patients that achieved at least a clinical response was 71.1%, with 19.3% achieving clinical remission. Of the 74 patients with a follow-up pouchoscopy, the proportion of patients with endoscopic response and mucosal healing was 54.1% and 17.6%, respectively. Patients who developed pouchitis symptoms less than 1 year after undergoing IPAA were less likely to respond to vedolizumab, even after controlling for other risk factors. CONCLUSIONS:
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Authors | Martin Gregory, Kimberly N Weaver, Patrick Hoversten, Stephen Bradley Hicks, Devin Patel, Matthew A Ciorba, Alexandra M Gutierrez, Poonam Beniwal-Patel, Sowmya Palam, Gaurav Syal, Hans H Herfarth, George Christophi, Laura Raffals, Edward L Barnes, Parakkal Deepak |
Journal | Inflammatory bowel diseases
(Inflamm Bowel Dis)
Vol. 25
Issue 9
Pg. 1569-1576
(08 20 2019)
ISSN: 1536-4844 [Electronic] England |
PMID | 30810748
(Publication Type: Journal Article, Multicenter Study, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
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Copyright | © 2019 Crohn’s & Colitis Foundation. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: [email protected]. |
Chemical References |
- Antibodies, Monoclonal, Humanized
- Gastrointestinal Agents
- vedolizumab
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Topics |
- Adult
- Antibodies, Monoclonal, Humanized
(therapeutic use)
- Crohn Disease
(surgery)
- Drug Resistance
(drug effects)
- Female
- Follow-Up Studies
- Gastrointestinal Agents
(therapeutic use)
- Humans
- Male
- Middle Aged
- Pouchitis
(drug therapy, etiology)
- Proctocolectomy, Restorative
(adverse effects)
- Prognosis
- Retrospective Studies
- United States
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