Remission Is Maintained after Switch from Dose-Optimised Intravenous Treatment to Subcutaneous Treatment with Vedolizumab in Inflammatory Bowel Disease
<i>Background and Objectives</i>: The subcutaneous (SC) formulation of vedolizumab has proven to be effective for the maintenance of remission after intravenous induction. Little is known about the efficacy of switching from intravenous maintenance treatment to SC. We aimed to assess the...
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MDPI AG
2024-02-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/60/2/296 |
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| author | Špela Pintar Jurij Hanžel David Drobne Matic Koželj Tina Kurent Nataša Smrekar Gregor Novak |
| author_facet | Špela Pintar Jurij Hanžel David Drobne Matic Koželj Tina Kurent Nataša Smrekar Gregor Novak |
| author_sort | Špela Pintar |
| collection | DOAJ |
| description | <i>Background and Objectives</i>: The subcutaneous (SC) formulation of vedolizumab has proven to be effective for the maintenance of remission after intravenous induction. Little is known about the efficacy of switching from intravenous maintenance treatment to SC. We aimed to assess the real-world efficacy of switching to SC treatment and to assess the impact of a baseline treatment regimen. <i>Materials and Methods</i>: In this observational cohort study, adult patients with inflammatory bowel disease who were switched to SC vedolizumab maintenance treatment were enrolled. Patients after intravenous induction and patients who switched from intravenous maintenance treatment (every 8 weeks or every 4 weeks) were included. The SC vedolizumab dosing was 108 mg every 2 weeks, regardless of the previous regimen. The clinical, biochemical, and endoscopic disease activity parameters and vedolizumab serum concentrations at the time of the switch and at the follow-up were assessed. <i>Results</i>: In total, 135 patients (38% Crohn’s disease, 62% ulcerative colitis) were switched to SC vedolizumab treatment. The median time to the first follow-up (FU) was 14.5 weeks (IQR 12–26), and the median time to the second FU was 40 weeks (IQR 36–52). Nine patients (7%) discontinued SC vedolizumab treatment, with two-thirds of them discontinuing due to active disease. In all dosing regimens, there were no significant changes in the clinical scores and CRP at the baseline and first and second FUs. Clinical and biochemical remission appeared to be maintained irrespective of the previous dosing regimen. <i>Conclusions</i>: The results of this real-world study suggest that the maintenance of clinical and biomarker remission can be achieved in patients who switched from intravenous to SC vedolizumab. The baseline vedolizumab dosing regimen (every 4 weeks versus every 8 weeks) did not have an impact on outcomes. |
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| language | English |
| last_indexed | 2024-03-07T22:21:34Z |
| publishDate | 2024-02-01 |
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| series | Medicina |
| spelling | doaj.art-386e4f6567614937bc50423713f528752024-02-23T15:26:41ZengMDPI AGMedicina1010-660X1648-91442024-02-0160229610.3390/medicina60020296Remission Is Maintained after Switch from Dose-Optimised Intravenous Treatment to Subcutaneous Treatment with Vedolizumab in Inflammatory Bowel DiseaseŠpela Pintar0Jurij Hanžel1David Drobne2Matic Koželj3Tina Kurent4Nataša Smrekar5Gregor Novak6Department of Gastroenterology, University Medical Centre Ljubljana, Japljeva 2, 1000 Ljubljana, SloveniaDepartment of Gastroenterology, University Medical Centre Ljubljana, Japljeva 2, 1000 Ljubljana, SloveniaDepartment of Gastroenterology, University Medical Centre Ljubljana, Japljeva 2, 1000 Ljubljana, SloveniaDepartment of Gastroenterology, University Medical Centre Ljubljana, Japljeva 2, 1000 Ljubljana, SloveniaDepartment of Gastroenterology, University Medical Centre Ljubljana, Japljeva 2, 1000 Ljubljana, SloveniaDepartment of Gastroenterology, University Medical Centre Ljubljana, Japljeva 2, 1000 Ljubljana, SloveniaDepartment of Gastroenterology, University Medical Centre Ljubljana, Japljeva 2, 1000 Ljubljana, Slovenia<i>Background and Objectives</i>: The subcutaneous (SC) formulation of vedolizumab has proven to be effective for the maintenance of remission after intravenous induction. Little is known about the efficacy of switching from intravenous maintenance treatment to SC. We aimed to assess the real-world efficacy of switching to SC treatment and to assess the impact of a baseline treatment regimen. <i>Materials and Methods</i>: In this observational cohort study, adult patients with inflammatory bowel disease who were switched to SC vedolizumab maintenance treatment were enrolled. Patients after intravenous induction and patients who switched from intravenous maintenance treatment (every 8 weeks or every 4 weeks) were included. The SC vedolizumab dosing was 108 mg every 2 weeks, regardless of the previous regimen. The clinical, biochemical, and endoscopic disease activity parameters and vedolizumab serum concentrations at the time of the switch and at the follow-up were assessed. <i>Results</i>: In total, 135 patients (38% Crohn’s disease, 62% ulcerative colitis) were switched to SC vedolizumab treatment. The median time to the first follow-up (FU) was 14.5 weeks (IQR 12–26), and the median time to the second FU was 40 weeks (IQR 36–52). Nine patients (7%) discontinued SC vedolizumab treatment, with two-thirds of them discontinuing due to active disease. In all dosing regimens, there were no significant changes in the clinical scores and CRP at the baseline and first and second FUs. Clinical and biochemical remission appeared to be maintained irrespective of the previous dosing regimen. <i>Conclusions</i>: The results of this real-world study suggest that the maintenance of clinical and biomarker remission can be achieved in patients who switched from intravenous to SC vedolizumab. The baseline vedolizumab dosing regimen (every 4 weeks versus every 8 weeks) did not have an impact on outcomes.https://www.mdpi.com/1648-9144/60/2/296inflammatory bowel diseaseCrohn’s diseaseulcerative colitisvedolizumabsubcutaneous formulation |
| spellingShingle | Špela Pintar Jurij Hanžel David Drobne Matic Koželj Tina Kurent Nataša Smrekar Gregor Novak Remission Is Maintained after Switch from Dose-Optimised Intravenous Treatment to Subcutaneous Treatment with Vedolizumab in Inflammatory Bowel Disease Medicina inflammatory bowel disease Crohn’s disease ulcerative colitis vedolizumab subcutaneous formulation |
| title | Remission Is Maintained after Switch from Dose-Optimised Intravenous Treatment to Subcutaneous Treatment with Vedolizumab in Inflammatory Bowel Disease |
| title_full | Remission Is Maintained after Switch from Dose-Optimised Intravenous Treatment to Subcutaneous Treatment with Vedolizumab in Inflammatory Bowel Disease |
| title_fullStr | Remission Is Maintained after Switch from Dose-Optimised Intravenous Treatment to Subcutaneous Treatment with Vedolizumab in Inflammatory Bowel Disease |
| title_full_unstemmed | Remission Is Maintained after Switch from Dose-Optimised Intravenous Treatment to Subcutaneous Treatment with Vedolizumab in Inflammatory Bowel Disease |
| title_short | Remission Is Maintained after Switch from Dose-Optimised Intravenous Treatment to Subcutaneous Treatment with Vedolizumab in Inflammatory Bowel Disease |
| title_sort | remission is maintained after switch from dose optimised intravenous treatment to subcutaneous treatment with vedolizumab in inflammatory bowel disease |
| topic | inflammatory bowel disease Crohn’s disease ulcerative colitis vedolizumab subcutaneous formulation |
| url | https://www.mdpi.com/1648-9144/60/2/296 |
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