Outcomes of treatment cessation after switching to subcutaneous vedolizumab treatment in inflammatory bowel diseases

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Abstract
Background: The usability of subcutaneous vedolizumab (s.c. VDZ) treatment in inflammatory bowel diseases (IBD; ulcerative colitis (UC), Crohn’s disease (CD)) has been proven via clinical trials while real-world data collection is ongoing. Objectives: Our study evaluates the effectiveness, safety, patients’ preferences, and psychological factors associated with s.c. VDZ treatment, after switching from intravenous (i.v.) formulation. Design: Prospective, multicenter cohort study including IBD patients switching from i.v. VDZ to s.c. treatment and were evaluated over 52 weeks. Methods: Serum VDZ levels and C-reactive protein (CRP) were measured at the baseline and w52. At w12, a questionnaire on the patient’s satisfaction and psychological characteristics was administered. The primary outcome was the drug persistence rate (cessation was due to loss of response (LOR), adverse events, patient request, and other causes) at w52, while the secondary outcomes were the changes in the clinical corticosteroid-free remission (CSFR) and biochemical remission (BR; CRP ⩽ 5 mg/L) rates, safety issues, serum drug levels, patients’ preferences, and psychological features. Results: In total, 70 IBD patients were evaluated (32 CD patients, 38 UC patients; male/female ratio: 41.4%; median age: 43.2 years). In the CD group, 81.3% were in CSFR and 65.6% were in BR, while in the UC group, 71.7% were in CSFR and 69.4% were in BR. Overall, 17.1% of the patients ceased s.c. VDZ treatment after a median of 26.2 (interquartile range 20–47) weeks. LOR was registered in 3/12 ceased patients. In addition, CSFR and BR rates were stable, while serum VDZ levels increased by w52 ( p < 0.001). Conclusion: The transition from i.v. to s.c. VDZ treatment was effective, the overall persistence rate was associated with high serum drug levels, and no novel safety issues were reported. Although s.c. administration after induction can save resources, some patients still insisted on i.v. VDZ treatment, due to its proven formulation.
Funding Information
  • Horizon 2020 Framework Programme (739593)
  • Emberi Eroforrások Minisztériuma (UNKP- 23-3 -SZTE-268)
  • Emberi Eroforrások Minisztériuma (UNKP-22-4 -SZTE-293)
  • Emberi Eroforrások Minisztériuma (UNKP-22-4-SZTE-296)
  • Emberi Eroforrások Minisztériuma (UNKP-23-3-SZTE-317)
  • Szegedi Tudományegyetem
  • Nemzeti Kutatási, Fejlesztési és Innovaciós Alap (125377)
  • Nemzeti Kutatási, Fejlesztési és Innovaciós Alap (129266)
  • Nemzeti Kutatási, Fejlesztési és Innovaciós Alap (134863)
  • Nemzeti Kutatási, Fejlesztési és Innovaciós Alap (143549)
  • Nemzeti Kutatási, Fejlesztési és Innovaciós Alap (BO/00598/19/5)
  • Szent-Györgyi Albert Orvostudományi Kar, Szegedi Tudományegyetem

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