Vedolizumab may have a corticosteroid sparing effect in real-world clinical practice, a new Finnish study reveals.
The incidence of inflammatory bowel disease (IBD), which include ulcerative colitis (UC) and Crohn’s disease (CD), is increasing worldwide. Accumulating data from clinical trials and real-world studies has demonstrated that vedolizumab, an anti-integrin antibody, is an effective and well-tolerated biological treatment for patients with IBD. In real-life clinical practice, vedolizumab is often used concomitantly with corticosteroids or other conventional therapies. Although corticosteroids use may increase the percentage of patients achieving clinical response or remission with vedolizumab treatment, their long-term use is associated with a wide variety of well-documented adverse effects. Thus, corticosteroid-free remission is an important treatment goal in the management of IBD.
A recent real-world cohort study evaluated concomitant corticosteroid, immunosuppressive, and 5-aminosalicylic acid (5-ASA) utilization in IBD patients treated with vedolizumab in Finland. The study was based on a unique nationwide FINVEDO cohort, which included all adult IBD patients from 27 Finnish gastroenterology centres (n=247) treated with vedolizumab since its availability in Finland.
According to this study, 60% of UC and 44% of CD patients were taking corticosteroids at the time of vedolizumab treatment initiation. Notably, the majority of patients (55% of CD and 70% of UC patients), who used corticosteroids at baseline and persisted on vedolizumab, were steroid-free at 6 months post-treatment initiation. In addition, corticosteroid doses decreased in vedolizumab treatment persistent CD patients at month 6. Corticosteroid users also had less vedolizumab discontinuations due to primary ineffectiveness and more discontinuations due to adverse events than patients not using corticosteroids.
This was the first study reporting detailed characterization of treatments used concomitantly with vedolizumab. The data suggests that vedolizumab may have a significant corticosteroid-sparing effect in real-world clinical practice.
The study was supported by Takeda Oy.
Ylisaukko-oja T, Torvinen S, Aaltonen J. et al. Characterization of inflammatory bowel disease management by vedolizumab and concomitant treatments in real-life clinical practice. Biologicals. 2019 Mar;58:50-56.