P505 Real word long-term efficacy and safety of vedolizumab in managing ulcerative colitis versus crohn’s disease: results from “long vedo” italian multicenter study

G Mocci,G Maconi,F M Onidi,G Cataletti,W Elisei,F Scaldaferri,R Lorenzetti,C Pagnini,A Scarcelli,M G Graziani,M C Di Paolo,G Pranzo,I Luppino,R Monterubbianesi,R Faggiani,A Ferronato,E Savarino,R Pica, A Cocco, S Rodino, L Sebkova, C Zampaletta,F Gaiani, L Fanigliulo, L Allegretta, A Cuomo, L Donnarumma,N Della Valle, G Forti,E Antonelli,G Bassotti, C Iannelli, G Aragona, A Lauria, S Piergallini, R Colucci,L Binaghi, C Meucci,A Papa, A Tursi

Journal of Crohn's and Colitis(2023)

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摘要
Abstract Background Current data about long-term use of vedolizumab (VDZ) in ulcerative colitis (UC) versus Crohn’s disease (CD) patients are limited. We aimed to assess whether there are differences in term of long-term efficacy and safety of VDZ in UC vs. CD patients. Methods Clinical activity was scored according to the Mayo score in UC and to the Harvey-Bradshaw Index (HBI) in CD. The primary endpoints were the achievement of clinical remission within 6 month of treatment, maintenance of clinical remission during a long follow-up, and safety. Secondary endpoints were clinical response to treatment, achievement of mucosal healing (MH), steroid discontinuation, and treatment optimization during the follow-up. Results The study group consisted of 729 patients (475 patients with UC and 254 CD patients with CD) with a median follow-up of 18 (interquartile range 6-36) months. Clinical remission at the 6th month of treatment was achieved in 488 (66.9%) patients, higher in CD patients (74.4 vs. 62.9, p<0.000) while, at the maximal follow-up, it was achieved and maintained in 81.5% of patients (UC vs. CD, p=0.667). At uni- and multivariate analysis, reaching clinical remission at the 6th month of treatment (p=0.001) and being naïve to biologics were significantly associated with longer clinical remission (p<0.0001). Long-term follow up clinical response was significantly higher in UC vs. CD (p=0.023) and surgery occurred more frequently in CD (p=0.04), while no difference were found between UC and CD about the other secondary endpoints Conclusion Overall, no significant differences were found about the long-term use of VDZ in UC vs. CD. However, we identified some parameters the can help the physician to predict the long-term efficacy of this drug.
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