Intestinal Research

Original Article

Factors affecting 1-year persistence with vedolizumab for ulcerative colitis: a multicenter, retrospective real-world study: Taku Kobayashi, Tadakazu Hisamatsu, Satoshi Motoya, Toshimitsu Fujii, Reiko Kunisaki, Tomoyoshi Shibuya, Minoru Matsuura, Ken Takeuchi, Sakiko Hiraoka, Hiroshi Yasuda, Kaoru Yokoyama, Noritaka Takatsu, Atsuo Maemoto, Toshiyuki Tahara, Keiichi Tominaga, Masaaki Shimada, Nobuaki Kuno, Jovelle L. Fernandez, Kaori Ishiguro, Mary Cavaliere, Hisato Deguchi, Toshifumi Hibi; Received May 1, 2024 Accepted October 5, 2024 Published online January 16, 2025; DOI: https://doi.org/10.5217/ir.2024.00063 [Epub ahead of print]

Abstract PDF Supplementary Material PubReader ePub: Background/Aims
The objectives of this real-world study were to determine 1-year persistence with vedolizumab in patients with ulcerative colitis and to evaluate factors contributing to loss of response.
Methods
In this multicenter, retrospective, observational chart review, patients with moderately to severely active ulcerative colitis who received ≥ 1 dose of vedolizumab in clinical practice at 16 tertiary hospitals in Japan (from December 2018 through February 2020) were enrolled.
Results
Persistence with vedolizumab was 64.5% (n = 370); the median follow-up time was 53.2 weeks. Discontinuation due to loss of response among initial clinical remitters was reported in 12.5% (35/281) of patients. Multivariate analysis showed that concomitant use of tacrolimus (odds ratio [OR], 2.76; 95% confidence interval [CI], 1.00–7.62; P= 0.050) and shorter disease duration (OR for median duration ≥ 7.8 years vs. < 7.8 years, 0.33; 95% CI, 0.13–0.82; P= 0.017) were associated with discontinuation due to loss of response. Loss of response was not associated with prior use of anti-tumor necrosis factor alpha therapy, age at the time of treatment, disease severity, or concomitant corticosteroids or immunomodulators. Of the 25 patients with disease duration < 1 year, 32.0% discontinued due to loss of response.
Conclusions
Persistence with vedolizumab was consistent with previous reports. Use of tacrolimus and shorter disease duration were the main predictors of decreased persistence.

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Case Report

IBD

Successful remission of ulcerative colitis flare-up during pregnancy with adsorptive granulomonocytapheresis plus tacrolimus: Tomoyoshi Shibuya, Keiichi Haga, Masato Kamei, Koki Okahara, Shoko Ito, Masahito Takahashi, Osamu Nomura, Takashi Murakami, Masae Makino, Tomohiro Kodani, Dai Ishikawa, Naoto Sakamoto, Taro Osada, Tatsuo Ogihara, Sumio Watanabe, Akihito Nagahara; Intest Res 2018;16(3):484-488. Published online July 27, 2018; DOI: https://doi.org/10.5217/ir.2018.16.3.484

Abstract PDF PubReader ePub

Ulcerative colitis (UC) is 1 of the 2 major phenotypes of chronic inflammatory bowel disease (IBD), which afflicts millions of individuals throughout the world with debilitating symptoms that impair function and quality of life. Further, IBD often affects women during childbearing age. Indeed, UC activity frequently increases during pregnancy, and the medications used to induce remission may adversely affect the health of the mother and the unborn child. We report successful induction of a remission in a UC case who experienced a flare-up in the first trimester of pregnancy. Upon relapse, she was treated with steroids and adsorptive granulomonocytapheresis (GMA) with the Adacolumn plus tacrolimus. This combination therapy induced a stable remission that was maintained during her entire pregnancy. She gave birth to a healthy child at 36 weeks of pregnancy with no maternal or fetal complications. Our experience indicates that GMA, as a non-drug therapeutic intervention with a favorable safety profile, plus tacrolimus might be a relevant treatment option for patients with active IBD during pregnancy. A future study of a large cohort of pregnant patients should strengthen our findings.

Citations

Citations to this article as recorded by

Adsorptive cytapheresis in ulcerative colitis: A non‐pharmacological therapeutic approach revisited
Filippo Vernia, Angelo Viscido, Giovanni Latella
Journal of Clinical Apheresis.2023; 38(6): 746. CrossRef
Apheresis: A cell-based therapeutic tool for the inflammatory bowel disease
Farah Yasmin, Hala Najeeb, Unaiza Naeem, Abdul Moeed, Thoyaja Koritala, Salim Surani
World Journal of Clinical Cases.2022; 10(21): 7195. CrossRef
Reproductive Health in IBD Patients
Sanket Patel, Haleh Vaziri
Current Treatment Options in Gastroenterology.2021; 19(2): 237. CrossRef
Selective granulocyte and monocyte apheresis in inflammatory bowel disease: Its past, present and future
Xiu-Li Chen, Jing-Wei Mao, Ying-De Wang
World Journal of Gastrointestinal Pathophysiology.2020; 11(3): 43. CrossRef
Women’s Health and Ulcerative Colitis
Kindra Clark-Snustad, Madalina Butnariu, Anita Afzali
Gastroenterology Clinics of North America.2020; 49(4): 769. CrossRef

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