Vedolizumab in paediatric inflammatory bowel disease: A retrospective multi-centre experience from the paediatric IBD porto group of ESPGHAN

Oren Ledder, Amit Assa, Arie Levine, Johanna C. Escher, Lissy de Ridder, Frank Ruemmele, Neil Shah, Ron Shaoul, Victorien M. Wolters, Astor Rodrigues, Holm H. Uhlig, Carsten Posovsky, Kaija Leena Kolho, Christian Jakobsen, Shlomi Cohen, Dror S. Shouval, Tim de Meij, Javier Martin-de-Carpi, Lisa Richmond, Jiri BronskyMira Friedman, Dan Turner*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

80 Scopus citations

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 shortterm 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.

Original languageAmerican English
Pages (from-to)1230-1237
Number of pages8
JournalJournal of Crohn's and Colitis
Volume11
Issue number10
DOIs
StatePublished - 1 Oct 2017

Bibliographical note

Publisher Copyright:
© 2017 European Crohn's and Colitis Organisation (ECCO). Published by Oxford University Press. All rights reserved.

Keywords

  • Inflammatory bowel disease
  • Paediatric
  • Vedolizumab

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