Clinical Outcomes and Response Predictors of Vedolizumab Induction Treatment for Korean Patients With Inflammatory Bowel Diseases Who Failed Anti-TNF Therapy: A KASID Prospective Multicenter Cohort Study
- 주제(키워드) vedolizumab , Crohn disease , ulcerative colitis , Korea
- 주제(기타) Gastroenterology & Hepatology
- 설명문(일반) [Kim, Jeongseok] Keimyung Univ, Dept Internal Med, Sch Med, Daegu, South Korea; [Yoon, Hyuk] Seoul Natl Univ, Dept Internal Med, Bundang Hosp, Seongnam, South Korea; [Kim, Nayoung] Asan Med Ctr, Dept Biostat & Clin Epidemiol, Seoul, South Korea; [Lee, Kang-Moon] Catholic Univ Korea, Coll Med, Dept Internal Med, St Vincents Hosp, Seoul, South Korea; [Jung, Sung-Ae] Ewha Womans Univ, Dept Internal Med, Sch Med, Seoul, South Korea; [Choi, Chang Hwan] Chung Ang Univ, Dept Internal Med, Coll Med, Seoul, South Korea; [Kim, Eun Soo] Kyungpook Natl Univ, Sch Med, Dept Internal Med, Div Gastroenterol & Hepatol, Daegu, South Korea; [Jung, Yunho] Soonchunhyang Univ, Dept Med, Div Gastroenterol, Coll Med, Cheonan, South Korea; [Eun, Chang Soo] Hanyang Univ, Dept Internal Med, Guri Hosp, Guri, South Korea; [Kim, Tae Oh] Inje Univ, Haeundae Paik Hosp, Dept Internal Med, Coll Med, Busan, South Korea; [Kang, Sang-Bum] Catholic Univ Korea, Coll Med, Dept Internal Med, Div Gastroenterol,Daejeon St Marys Hosp, Daejeon, South Korea; [Kim, You Sun] Inje Univ, Seoul Paik Hosp, Dept Internal Med, Coll Med, Seoul, South Korea; [Seo, Geom-Seog] Wonkwang Univ, Dept Internal Med, Sch Med, Iksan, South Korea; [Lee, Chang Kyun] Kyung Hee Univ, Ctr Crohns & Colitis, Dept Gastroenterol, Coll Med, Seoul, South Korea; [Im, Jong Pil] Seoul Natl Univ, Dept Internal Med, Coll Med, Seoul, South Korea; [Im, Jong Pil] Seoul Natl Univ, Liver Res Inst, Coll Med, Seoul, South Korea; [Park, Soo Jung] Yonsei Univ, Severance Hosp, Dept Internal Med, Coll Med, Seoul, South Korea; [Park, Soo Jung] Yonsei Univ, Severance Hosp, Inst Gastroenterol, Coll Med, Seoul, South Korea; [Park, Dong Il] Sungkyunkwan Univ, Kangbuk Samsung Hosp, Dept Internal Med, Div Gastroenterol,Sch Med, 29 Saemunan Ro, Seoul 03181, South Korea; [Ye, Byong Duk] Univ Ulsan, Asan Med Ctr, Dept Gastroenterol, Coll Med, 88 Olymp Ro 43 Gil, Seoul 05505, South Korea; [Ye, Byong Duk] Univ Ulsan, Asan Med Ctr, Inflammatory Bowel Dis Ctr, Coll Med, 88 Olymp Ro 43 Gil, Seoul 05505, South Korea
- 등재 SCIE, SCOPUS
- 발행기관 OXFORD UNIV PRESS INC
- 발행년도 2021
- 총서유형 Journal
- URI http://www.dcollection.net/handler/ewha/000000190755
- 본문언어 영어
- Published As https://doi.org/10.1093/ibd/izaa361
초록/요약
Background: We investigated the real-life effectiveness and safety of vedolizumab (VDZ) induction therapy among Korean patients with Crohn disease (CD) or ulcerative colitis (UC) for whom anti-tumor necrosis factor therapy previously failed. Methods: Adult patients who started VDZ induction therapy at 16 centers were prospectively enrolled in the Korean VDZ nationwide registry. The coprimary outcomes were clinical remission, defined as a Crohn's Disease Activity Index score <150 points and a partial Mayo score <= 2 points with a combined rectal bleeding and stool frequency subscore <= 1 point at week 14 and endoscopic remission defined as a Mayo endoscopic subscore <= 1 point. We also analyzed predictors of clinical remission. Results: Between August 2017 and November 2019, a total of 158 patients (80 with CD and 78 with UC) received VDZ induction therapy. Clinical remission rates among patients with CD and patients with UC were 44.1% and 44.0%, respectively. Among patients with UC, the endoscopic remission rate was 32.4%. Clinical response and remission rates showed increasing trends during induction therapy. Multivariable analysis revealed that clinical response at week 6 was the only predictor of clinical remission at week 14 for both patients with CD and patients with UC. Among patients who experienced 1 or more adverse events (n = 71; 44.9%), disease exacerbation (n = 28; 17.7%) was the most common adverse event. Conclusions: Among Korean patients with CD or UC for whom anti-tumor necrosis factor therapy failed, VDZ induction therapy was effective and safe. The early clinical response was associated with clinical remission after VDZ induction therapy.
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