Long-term safety of vedolizumab in patients with ulcerative colitis/Crohn's disease: A prospective observational study.

IF 12 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY
Edouard Louis, Shaji Sebastian, Britta Siegmund, Peter Bossuyt, Silvio Danese, Nanne de Boer, Edward V Loftus, Bjørn Moum, Laurent Peyrin-Biroulet, Stefan Schreiber, Jie Zhou, Edith Angellotti, Shashi Adsul, Stephen Jones, Corey A Siegel
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Abstract

Background and aims: This post-authorization safety study compared long-term safety of vedolizumab or other biologics in patients with ulcerative colitis (UC) or Crohn's disease (CD).

Methods: This was a prospective, observational, multicentre, cohort study in patients with UC or CD starting treatment with vedolizumab or other biologics (NCT02674308, EUPAS6469). The primary safety outcome was serious infections compared between cohorts using a Cox proportional hazards model adjusted by propensity score. Clinical effectiveness was a secondary outcome.

Results: The full analysis set comprised 5,008 pts (vedolizumab=2,502; other biologic=2,506) and mean (standard deviation) follow-up duration was 37.4 (14.1) months. Patients in the vedolizumab group had greater age, duration of disease, and concomitant medication use at baseline, indicating more advanced disease. In patients with UC, the incidence rate per 100 person-years of serious infections was: 5.5 (95% CI: 4.7, 6.5) [vedolizumab] and 7.0 (5.8, 8.5) [other biologic], with an adjusted hazard ratio (HR) of 0.89 (0.69, 1.15), p=0.38. In patients with CD, corresponding findings were 7.9 (95% CI: 6.8, 9.1) [vedolizumab] and 6.5 (95% CI: 5.7, 7.3) [other biologic] with adjusted HR of 1.15 (0.95, 1.40), p=0.16. There were no safety issues relating to pregnancy and no cases of progressive multifocal leukoencephalopathy were observed. There were 18 deaths in the vedolizumab group and 13 in the other biologic group. Clinical effectiveness was comparable between cohorts and was similar to the levels seen in other prospective observations of vedolizumab.

Conclusion: There was no new safety signal identified in relation to vedolizumab. Results regarding safety and effectiveness were consistent with the known profile of vedolizumab.

vedolizumab治疗溃疡性结肠炎/克罗恩病的长期安全性:一项前瞻性观察性研究
背景和目的:这项授权后安全性研究比较了vedolizumab或其他生物制剂在溃疡性结肠炎(UC)或克罗恩病(CD)患者中的长期安全性。方法:这是一项前瞻性,观察性,多中心,队列研究,在UC或CD患者开始使用vedolizumab或其他生物制剂治疗(NCT02674308, EUPAS6469)。使用Cox比例风险模型(经倾向评分调整)比较各组间的主要安全结局是严重感染。临床疗效是次要结果。结果:完整的分析集包括5,008名患者(vedolizumab=2,502,其他生物制剂=2,506),平均(标准差)随访时间为37.4(14.1)个月。在基线时,vedolizumab组患者的年龄、疾病持续时间和伴随药物使用更大,表明疾病更晚期。在UC患者中,每100人年严重感染的发生率为:5.5 (95% CI: 4.7, 6.5) [vedolizumab]和7.0(5.8,8.5)[其他生物制剂],校正风险比(HR)为0.89 (0.69,1.15),p=0.38。在CD患者中,相应的结果为7.9 (95% CI: 6.8, 9.1) [vedolizumab]和6.5 (95% CI: 5.7, 7.3)[其他生物制剂],调整后的风险比为1.15 (0.95,1.40),p=0.16。没有与妊娠有关的安全问题,也没有观察到进行性多灶性白质脑病的病例。韦多单抗组有18例死亡,其他生物制剂组有13例死亡。临床有效性在队列之间具有可比性,并且与vedolizumab的其他前瞻性观察中的水平相似。结论:未发现与vedolizumab相关的新的安全性信号。关于安全性和有效性的结果与已知的vedolizumab一致。
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来源期刊
CiteScore
16.90
自引率
4.80%
发文量
903
审稿时长
22 days
期刊介绍: Clinical Gastroenterology and Hepatology (CGH) is dedicated to offering readers a comprehensive exploration of themes in clinical gastroenterology and hepatology. Encompassing diagnostic, endoscopic, interventional, and therapeutic advances, the journal covers areas such as cancer, inflammatory diseases, functional gastrointestinal disorders, nutrition, absorption, and secretion. As a peer-reviewed publication, CGH features original articles and scholarly reviews, ensuring immediate relevance to the practice of gastroenterology and hepatology. Beyond peer-reviewed content, the journal includes invited key reviews and articles on endoscopy/practice-based technology, health-care policy, and practice management. Multimedia elements, including images, video abstracts, and podcasts, enhance the reader's experience. CGH remains actively engaged with its audience through updates and commentary shared via platforms such as Facebook and Twitter.
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