Efficacy and Safety of Vedolizumab in the Treatment of Ulcerative Colitis in Real Clinical Practice: Five Years of Observation

O. Knyazev, A. Kagramanova, I. Li, A. Lischinskaya, E. Sabelnikova, N. Fadeeva, T. Shkurko, B. Nanaeva, T. Baranova, M.Yu. Timanovskaуа, A. Parfenov
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Abstract

In real clinical practice, unlike in the registered controlled trials, the analytical group includes all patients who are being treated with a drug. The aim is to evaluate the efficacy and safety of vedolizumab (VDMB) therapy in real clinical practice in patients with ulcerative colitis (UC) for five years. Material and methods. The study included 136 patients with UC (men 53.7%, women 46.3%), average age – 33.8 ± 4.4 years, duration of the disease – 3.1 ± 0.4 years (52.9% of patients with moderate severity, 72.1% with total lesion and 64.4% with chronic recurrent course, in 17.6% of cases – extra-intestinal manifestations). Results. After 12 weeks, 53 (38.9%) patients with UC achieved a clinical response, 72 (52.9%) achieved clinical remission, 13 (9.5%) did not respond or did not respond sufficiently to therapy. After 24 weeks, clinical remission reached 72.1%, clinical response – 18.4% of patients. Of 112 patients who underwent colonoscopy (CS), 68 (60.7%) had clinical and endoscopic remission at week 24. After 52 weeks of therapy, endoscopic remission persisted in 68 (60.7%) patients, endoscopic response – in 40 (36.6%), clinical remission – in 112 (82.3%) and clinical response – in 21 (15.4%). After five years of VDMB therapy, endoscopic remission persisted in 70 (51.5%) patients, endoscopic response in 36 (26.5%), clinical remission in 105 (77.2%) and clinical response in 19 (14.0%). The survival rate of VDMB therapy in patients with UC was 90.4% after 12 months and persisted for a year, 82.3% after two years, 81.6% after five years. Steroidal remission was 91.0%. The regression of extra-intestinal manifestations after 24 weeks was noted in 58.3% of patients with UC. Conclusion. Our clinical observation of 136 patients with UC demonstrated the high efficacy and safety of VDMB
Vedolizumab治疗溃疡性结肠炎的临床疗效和安全性:5年观察
在真正的临床实践中,与注册对照试验不同,分析组包括所有正在接受药物治疗的患者。目的是评估vedolizumab (VDMB)治疗溃疡性结肠炎(UC)患者5年的临床疗效和安全性。材料和方法。本研究纳入136例UC患者(男性53.7%,女性46.3%),平均年龄- 33.8±4.4岁,病程- 3.1±0.4年(52.9%为中度,72.1%为全病变,64.4%为慢性复发,17.6%为肠外表现)。结果。12周后,53例(38.9%)UC患者达到临床缓解,72例(52.9%)达到临床缓解,13例(9.5%)对治疗无反应或反应不充分。24周后,临床缓解率达72.1%,临床缓解率为18.4%。在112例接受结肠镜检查(CS)的患者中,68例(60.7%)在第24周时临床和内镜缓解。治疗52周后,68例(60.7%)患者的内窥镜缓解持续,40例(36.6%)患者的内窥镜缓解持续,112例(82.3%)患者的临床缓解持续,21例(15.4%)患者的临床缓解持续。经过5年的VDMB治疗,70例(51.5%)患者的内镜缓解持续,36例(26.5%)患者的内镜缓解持续,105例(77.2%)患者的临床缓解持续,19例(14.0%)患者的临床缓解持续。VDMB治疗UC患者12个月后生存率为90.4%,持续1年,2年生存率为82.3%,5年生存率为81.6%。类固醇缓解率为91.0%。24周后,58.3%的UC患者肠道外症状消退。结论。我们对136例UC患者的临床观察表明,VDMB具有较高的疗效和安全性
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