Vedolizumab in Paediatric Inflammatory Bowel Disease: A Retrospective Multi-Centre Experience From the Paediatric IBD Porto Group of ESPGHAN
Por:
Ledder O, Assa A, Levine A, Escher JC, de Ridder L, Ruemmele F, Shah N, Shaoul R, Wolters VM, Rodrigues A, Uhlig HH, Posovsky C, Kolho KL, Jakobsen C, Cohen S, Shouval DS, de Meij T, Martín-de-Carpi J, Richmond L, Bronsky J, Friedman M and Turner D
Publicada:
1 oct 2017
Ahead of Print:
9 jun 2017
Resumen:
Background: Vedolizumab, an anti-integrin antibody, has proven to be effective in adults with inflammatory bowel disease [IBD], but the data in paediatrics are limited. We describe the short-term effectiveness and safety of vedolizumab in a European multi-centre paediatric IBD cohort.
Method: Retrospective review of children [aged 2-18 years] treated with vedolizumab from 19 centres affiliated with the Paediatric IBD Porto group of ESPGHAN. Primary outcome was Week 14 corticosteroid-free remission [CFR].
Results: In all, 64 children were included (32 [50%] male, mean age 14.5 +/- 2.8 years, with a median follow-up 24 weeks [interquartile range 14-38; range 6-116]); 41 [64%] cases of ulcerative colitis/inflammatory bowel disease unclassified [UC/IBD-U] and 23 [36%] Crohn's disease [CD]. All were previously treated with anti-tumour necrosis factor [TNF] [28% primary failure, 53% secondary failure]. Week 14 CFR was 37% in UC, and 14% in CD [P = 0.06]. CFR by last follow-up was 39% in UC and 24% in CD [p = 0.24]. Ten [17%] children required surgery, six of whom had colectomy for UC. Concomitant immunomodulatory drugs did not affect remission rate [42% vs 35%; p = 0.35 at Week 22]. There were three minor drug-related adverse events. Only 3 of 16 children who underwent endoscopic evaluation had mucosal healing after treatment (19%).
Conclusions: Vedolizumab was safe and effective in this cohort of paediatric refractory IBD. These data support previous findings of slow induction rate of vedolizumab in CD and a trend to be less effective compared with patients with UC.
Filiaciones:
Ledder O:
The Hebrew University of Jerusalem, Israel
Assa A:
The Sackler faculty of Medicine, Tel Aviv University, Israel
Levine A:
Wolfson Medical Center, Holon,Israel
Escher JC:
Erasmus Medical Center, Rotterdam, Netherlands
de Ridder L:
Erasmus Medical Center, Rotterdam, Netherlands
Ruemmele F:
Hopital Necker Enfants Malades, Paris, France
Shah N:
Great Ormond Street Hospital, London, United Kingdom
Shaoul R:
Rambam Medical Center, Haifa, Israel
Wolters VM:
University Medical Center Utrecht, Netherlands
Rodrigues A:
Oxford University Children's Hospital, Department of Paediatrics, Oxford, United Kingdom
Uhlig HH:
Translational Gastroenterology Unit, Oxford University, United Kingdom
Posovsky C:
University Medical Center, Ulm, Germany
Kolho KL:
Helsinki University Central Hospital, Helsinki, Finland
Jakobsen C:
Hvidovre University Hospital, Copenhagen, Denmark
Cohen S:
'Dana-Dwek' Children's Hospital, Tel Aviv Medical Center, Tel Aviv, Israel
Shouval DS:
Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Israel
de Meij T:
VU Medical Centre, Amsterdam, Netherlands
Martín-de-Carpi J:
Hospital Sant Joan de Déu, Barcelona, Spain
Richmond L:
Royal Hospital for Sick Children, Glasgow, Scotland
Bronsky J:
University Hospital Motol, Prague, Czech Republic
Friedman M:
Shaare Zedek Medical Center, Jerusalem, Israel
Turner D:
The Hebrew University of Jerusalem, Israel
Bronze, Green Submitted
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