title: Predictors of Clinical Response and Remission at 1 Year Among a Multicenter Cohort of Patients with Inflammatory Bowel Disease Treated with Vedolizumab.
abstract: Vedolizumab (VDZ) has demonstrated long-term efficacy in Crohn's disease (CD) and ulcerative colitis (UC) in phase III trials.
  
  
  
  Our aim was to evaluate the efficacy of VDZ at week 54 in inflammatory bowel disease (IBD) in a multicenter cohort of patients.
  
  
  
  Adult patients completing induction therapy with VDZ were eligible for this study. Clinical response and remission was assessed using the Harvey-Bradshaw Index (HBI) for CD, the Simple Clinical Colitis Activity Index for UC and physician assessment.
  
  
  
  Among 136 total patients (96 CD and 40 UC), 76 (56%) demonstrated clinical response or remission at week 54. In univariate analysis, for patients with CD concomitant initiation of immunomodulator therapy (2.71, 95% CI 1.11-6.57), the addition of an immunomodulator (OR 11.49, 3.16-41.75) and CRP < 3 (4.92, 95% CI 1.99-12.15) was associated with increased odds of clinical response or remission at week 54. For UC patients, hospitalization after VDZ induction was associated with decreased odds of response or remission at week 54 (OR 0.22, 95% CI 0.05-0.88). On multivariate analysis in CD, addition of an immunomodulator (OR 8.33, 95% CI 2.15-32.26) remained significant predictors of clinical response or remission at week 54.
  
  
  
  Among a multicenter cohort of patients with IBD demonstrating primary response to VDZ, the addition of combination therapy with an immunomodulator is a significant predictor of clinical response or remission at week 54 in patients with CD.
authors.affiliation: Division of Gastroenterology, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02141, USA. jallegretti@bwh.harvard.edu.|Harvard Medical School, Boston, MA, USA. jallegretti@bwh.harvard.edu.
authors.forename: Jessica R
authors.initials: JR
authors.lastname: Allegretti
authors.affiliation: Division of Gastroenterology, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02141, USA.|Harvard Medical School, Boston, MA, USA.
authors.forename: Edward L
authors.initials: EL
authors.lastname: Barnes
authors.affiliation: Gastroenterology Unit, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Betsey
authors.initials: B
authors.lastname: Stevens
authors.affiliation: Division of Gastroenterology, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02141, USA.
authors.forename: Margaret
authors.initials: M
authors.lastname: Storm
authors.affiliation: Gastroenterology Unit, Massachusetts General Hospital, Boston, MA, USA.|Harvard Medical School, Boston, MA, USA.
authors.forename: Ashwin
authors.initials: A
authors.lastname: Ananthakrishnan
authors.affiliation: Gastroenterology Unit, Massachusetts General Hospital, Boston, MA, USA.|Harvard Medical School, Boston, MA, USA.
authors.forename: Vijay
authors.initials: V
authors.lastname: Yajnik
authors.affiliation: Division of Gastroenterology, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02141, USA.|Harvard Medical School, Boston, MA, USA.
authors.forename: Joshua
authors.initials: J
authors.lastname: Korzenik
mesh_terms: D000328:Adult; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D002097:C-Reactive Protein / Q000378:metabolism; D003093:Colitis, Ulcerative / Q000097:blood / Q000188:drug therapy*; D003424:Crohn Disease / Q000097:blood / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D005260:Female; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006760:Hospitalization; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012074:Remission Induction; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D005765:Gastrointestinal Agents; D007155:Immunologic Factors; D002097:C-Reactive Protein; C543529:vedolizumab
keywords: Combination therapy; Crohn’s disease; Immunomodulator; Inflammatory bowel disease; Ulcerative colitis; Vedolizumab