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Maintenance of Remission Among Patients With Inflammatory Bowel Disease After Vedolizumab Discontinuation: A Multicentre Cohort Study

2020; Oxford University Press; Volume: 14; Issue: 7 Linguagem: Inglês

10.1093/ecco-jcc/jjaa005

1876-4479

Antoine Martin, Maria Nachury, Laurent Peyrin‐Biroulet, Yoram Bouhnik, Stéphane Nancey, Anne Bourrier, Mélanie Serrero, Mathurin Fuméry, Anthony Buisson, David Laharie, Cyrielle Gilletta, Jerome Filippi, Matthieu Allez, Guillaume Bouguen, Xavier Roblin, Romain Altwegg, Nina Dib, Guillaume Pineton de Chambrun, Guillaume Savoye, Franck Carbonnel, Stéphanie Viennot, Aurelien Amiot, Aurélien Amiot, Antoine Martin, Charlotte Gagnière, Maria Nachury, Benjamin Pariente, Pauline Wils, Laurent Peyrin‐Biroulet, Camille Zallot, Yoram Bouhnik, Xavier Treton, Carmen Stefănescu, Stéphane Nancey, Gilles Boschetti, Philippe Seksik, Laurent Beaugerie, Julien Kirchgesner, Anne Bourrier, Harry Sokol, Mélanie Serrero, Mathurin Fuméry, Clara Yzet, Franck Brazier, David Laharie, Pauline Rivière, Florian Poullenot, Anthony Buisson, Cyrielle Gilletta, Jérôme Filippi, Xavier Hébuterne, Matthieu Allez, Jean‐Marc Gornet, Guillaume Bouguen, Laurent Siproudhis, Xavier Roblin, Romain Altwegg, Guillaume Pineton de Chambrun, Nina Dib, Guillaume Savoye, Franck Carbonnel, Antoine Meyer, Stéphanie Viennot, Guillaume Lebaut,

Celiac Disease Research and Management

It is unclear whether vedolizumab therapy can be discontinued in patients with inflammatory bowel disease [IBD] after achieving steroid-free clinical remission. The aim was to assess the risk of relapse after vedolizumab therapy was discontinued.This was a retrospective observational study, collecting data from 21 tertiary centres affiliated with the GETAID from January 2017 to April 2019. Consecutive patients with IBD, who were in steroid-free clinical remission for at least 3 months and were treated with vedolizumab for at least 6 months, were included at the time of vedolizumab discontinuation.A total of 95 patients [58 with Crohn's disease] discontinued vedolizumab after a median duration of therapy of 17.5 [10.6-25.4] months. After a median follow-up period of 11.2 [5.8-17.7] months, 61 [64%] patients experienced disease relapse. The probabilities of relapse-free survival were 83%, 59%, and 36% at 6, 12, and 18 months, respectively. According to the multivariate analysis, a C-reactive protein level less than 5 mg/L at vedolizumab discontinuation (hazard ratio [HR] = 0.56, 95% confidence interval [CI] [0.33-0.95], p = 0.03) and discontinuation due to patients' elective choice (HR = 0.41, 95% CI [0.21-0.80], p = 0.009) were significantly associated with a lower risk of relapse. Re-treatment with vedolizumab was noted in 24 patients and provided steroid-free clinical remission in 71% and 62.5% at Week 14 and after a median follow-up of 11.0 [5.4-13.3] months, respectively, without any infusion reactions.In this retrospective study, two-thirds of patients with IBD treated with vedolizumab experienced relapse within the first year after vedolizumab discontinuation. Re-treatment with vedolizumab was effective in two-thirds of patients.