Shaji Sebastian

Credit: Hull University Teaching Hospital

New research shows better outcomes for biologic-naïve patients with inflammatory bowel disease (IBD) after they are treated with vedolizumab compared to other biologic treatments.¹

A team, led by Shaji Sebastian, Hull University Teaching Hospital, IBD Unit, evaluated the number of hospitalizations and surgeries among patients with ulcerative colitis and Crohn’s disease initiating vedolizumab or other biologics as a marker for disease modification and health resource utilization.

The data was presented during the European Crohn’s and Colitis Organization 2023 Meeting in Copenhagen.

The Problem

One of the largest drivers of health resource utilization and an increasing disease burden for patients with IBD are hospitalizations and surgeries.

In the multicenter, observational, prospective, cohort post-authorization safety study, the investigators examined biologic-naïve patients with ulcerative colitis or Crohn’s disease initiating vedolizumab or other biologics using secondary outcome data.

Each participant received treatment as routine standard of care with clinical decisions at the discretion of the treating physician. Treatment could be modified or changed without the patient needing to withdraw from the study.

The investigators assessed IBD-related hospitalization rates and the occurrences of IBD-related surgeries, as well as the time to first hospitalization and surgery in patients with IBD initiating vedolizumab or other biologic therapies.

The Patients

The patient population included 1149 individuals with ulcerative colitis, 556 of which initiated vedolizumab. The remaining 593 participants in the ulcerative colitis cohort were treated with other biologics. On the other side, there were 1338 patients with Crohn’s disease, 312 of which were treated with vedolizumab and 1026 of which were treated with other biologics.

The results show patients with ulcerative colitis treated with vedolizumab had fewer IBD-related hospitalizations (12.9% vs 25.0%; risk ratio [RR], 0.52; 95% confidence interval [CI], 0.40-0.67) and IBD-related surgeries (4.3% vs 10.1%; RR, 0.43; 95% CI, 0.27-0.68) compared to patients with ulcerative colitis treated with other biologics.

After looking at the data on surgical procedures, the investigators found patients with ulcerative colitis treated with vedolizumab had fewer IBD-related hospitalizations (19.2% vs 26.4%; RR, 0.73; 95% CI, 0.57-0.93) and IBD-related surgeries (7.1% vs 13.8%; RR, 0.51; 95% CI, 0.33-0.78) than those treated with other biologics.

This group also had a longer time to event of first IBD-related hospitalization and primary and secondary IBD-related surgery in patients without a history of IBD-related surgery at baseline.

“In this large multinational, observational study, fewer biologic-naïve pts with [ulcerative colitis] or [Crohn's disease] on [vedolizumab] treatment had hospitalizations and IBD-related surgeries than pts on other biologics,” the authors wrote. “These real-world data suggest [vedolizumab] as a first line biologic treatment may contribute to modifying the course of IBD over time. Further research into the role of additional factors associated with differences in biologic treatments shown here is warranted.”

References:

S Sebastian, C Siegel, B Siegmund, J Zhou, S Jones, S Adsul, E Louis, DOP84 IBD-related hospitalization and surgery rates in biologic-naïve patients with IBD treated with vedolizumab versus other biologics: Results from a long-term, prospective, observational study, Journal of Crohn's and Colitis, Volume 17, Issue Supplement_1, February 2023, Pages i159–i160, https://doi.org/10.1093/ecco-jcc/jjac190.0124