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J Crohns Colitis. 2017 Oct 1;11(10):1230-1237. doi: 10.1093/ecco-jcc/jjx082.

Vedolizumab in Paediatric Inflammatory Bowel Disease: A Retrospective Multi-Centre Experience From the Paediatric IBD Porto Group of ESPGHAN.

Author information

1
Shaare Zedek Medical Center, Jerusalem, Israel.
2
Hebrew University of Jerusalem, Jerusalem, Israel.
3
Schneider Medical Center, Petach Tikva, Israel.
4
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
5
Wolfson Medical Center, Holon, Israel.
6
Erasmus Medical Center, Rotterdam, The Netherlands.
7
Hopital Necker Enfants Malades, Paris, France.
8
Great Ormond Street Hospital, London, UK.
9
Rambam Medical Center, Haifa, Israel.
10
University Medical Center Utrecht, Utrecht, The Netherlands.
11
Oxford University Children's Hospital,Oxford, UK.
12
Oxford University Children's Hospital, Oxford, UK.
13
Translational Gastroenterology Unit, Oxford University, UK.
14
University Medical Center, Ulm, Germany.
15
Helsinki University Central Hospital, Helsinki, Finland.
16
Hvidovre University Hospital, Copenhagen, Denmark.
17
'Dana-Dwek' Children's Hospital, Tel Aviv, Israel.
18
Edmond and Lily Safra Children's Hospital, Tel Hashomer, Israel.
19
VU Medical Centre, Amsterdam, The Netherlands.
20
Hospital Sant Joan de Deu, Barcelona, Spain.
21
Royal Hospital for Sick Children, Glasgow, Uk.
22
University Hospital Motol, Prague, Czech Republic.

Abstract

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.

KEYWORDS:

Vedolizumab; inflammatory bowel disease; paediatric

PMID:
28605483
DOI:
10.1093/ecco-jcc/jjx082
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