The use of vedolizumab for the treatment of inflammatory bowel disease patients in the Czech Republic
Přemysl Falt Orcid.org 1
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Summary
Background: Vedolizumab is a novel anti-integrin antibody that selectively blocks lymphocyte migration into the gastrointestinal tract (GIT). Since March 2016, vedolizumab has been used for the treatment of inflammatory bowel disease (IBD) patients in the Czech Republic. Methods: The Czech registry of IBD patients on biological therapy CREDIT provided data on patients who started vedolizumab treatment. Data were analyzed using descriptive statistical methods. Results: A total of 43 patients were included, 72% with Crohn’s disease (CD), 26% with ulcerative colitis (UC), and 2% with unspecified IBD. Seventy-four per cent of CD patients suffered from inflammatory type of disease, 39% from anal, and 29% from upper GIT involvemen; 82% of UC patients had extensive colitis. In 97% of CD patients, vedolizumab treatment was indicated for luminal disease, in 26% for anal involvement, and in 7% for extraintestinal manifestation. In 73% of UC patients, treatment was started after failure of conventional therapy. In 27% of UC patients, rescue therapy was reported. Except for 16% of CD patients in remission, all patients showed signs of clinical activity. In all cases, vedolizumab was started after therapy with the biologic agent anti-TNF-α failed (61% as the third, 23% as the second, and 16% as the fourth line biologic). The reasons for failure were loss of response, primary non-response, and intolerance. In CD and UC patients, 39% and 73%, respectively, were on corticosteroids when they started vedolizumab therapy. Conclusion: In clinical practice in the Czech Republic, vedolizumab has been used for the treatment of IBD patients with luminal disease after failure of or intolerance to anti-TNF-α treatment.
Keywords
Crohn’s disease, ulcerative colitis, vedolizumab
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