Long-term outcomes of vedolizumab in inflammatory bowel disease: the Swedish prospective multicentre SVEAH extension study

Isabella Visuri; Carl Eriksson; Sara Karlqvist; Byron Lykiardopoulos; Per Karlén; Olof Grip; Charlotte Söderman; Sven Almer; Erik Hertervig; Jan Marsal; Carolina Malmgren; Jenny Delin; Hans Strid; Mats Sjöberg; Daniel Bergemalm; Henrik Hjortswang; Jonas Halfvarson

doi:10.1177/17562848231174953

Long-term outcomes of vedolizumab in inflammatory bowel disease: the Swedish prospective multicentre SVEAH extension study

Therap Adv Gastroenterol. 2023 May 30:16:17562848231174953. doi: 10.1177/17562848231174953. eCollection 2023.

Authors

Isabella Visuri¹, Carl Eriksson^{2

3}, Sara Karlqvist², Byron Lykiardopoulos⁴, Per Karlén⁵, Olof Grip⁶, Charlotte Söderman⁷, Sven Almer^{8

9}, Erik Hertervig⁶, Jan Marsal⁶, Carolina Malmgren¹⁰, Jenny Delin¹¹, Hans Strid¹², Mats Sjöberg¹³, Daniel Bergemalm², Henrik Hjortswang^{4

14}, Jonas Halfvarson²

Affiliations

¹ Department of Gastroenterology, Faculty of Medicine and Health, Örebro University, Södra Grev Rosengatan 30, Örebro, SE-70182 Sweden.
² Department of Gastroenterology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
³ Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
⁴ Department of Gastroenterology and Hepatology, Linköping University, Linköping, Sweden.
⁵ Department of Internal Medicine, Danderyd Hospital, Stockholm, Sweden.
⁶ Department of Gastroenterology, Skåne University Hospital, Malmö/Lund, Sweden.
⁷ Department of Internal Medicine, St Göran Hospital, Stockholm, Sweden.
⁸ Department of Medicine Solna, Division of Gastroenterolgy, Karolinska Institutet, Stockholm, Sweden.
⁹ IBD-Unit, Division of Gastroenterology, Karolinska University Hospital, Stockholm, Sweden.
¹⁰ Takeda Pharma AB, Stockholm, Sweden.
¹¹ Department of Gastroenterology, Ersta Hospital, Stockholm, Sweden.
¹² Department of Internal Medicine, Södra Älvsborgs Hospital, Borås, Sweden.
¹³ Department of Internal Medicine, Skaraborgs Hospital, Lidköping, Sweden.
¹⁴ Department of Health, Medicine, and Caring Sciences, Linköping University, Linköping, Sweden.

Abstract

Background: Real-world data on long-term outcomes of vedolizumab (VDZ) are scarce.

Objective: To assess long-term outcomes (up to 3 years) of VDZ in treating inflammatory bowel disease (IBD).

Design: A nationwide, prospective multicentre extension of a Swedish observational study on VDZ assessing Effectiveness And Healthcare resource utilization in patients with IBD (SVEAH).

Methods: After re-consent, data of patients with Crohn's disease (CD) (n = 68) and ulcerative colitis (UC) (n = 46) treated with VDZ were prospectively recorded using an electronic case report form integrated with the Swedish IBD Register (SWIBREG). The primary outcome was clinical remission (defined as Harvey-Bradshaw Index ⩽4 in CD and partial Mayo score ⩽2 in UC) at 104 and 156 weeks in patients with a response and/or remission 12 weeks after starting VDZ. Secondary outcomes included health-related quality of life (HRQoL) and biochemical outcomes.

Results: VDZ continuation rates were high at weeks 104 and 156, 88% and 84%, respectively, for CD and 87% and 78%, respectively, for UC. Of the 53 CD patients with a response/remission at 12 weeks, 40 (75%) patients were in remission at 104 weeks and 42 (79%) patients at 156 weeks. For UC, these numbers were 25/31 (81%) and 22/31 (71%), respectively. Improvements were seen in the Short Health Scale (p < 0.01 for each dimension; CD, n = 51; UC, n = 33) and the EuroQol 5-Dimensions, 5-levels index value (p < 0.01; CD, n = 39; UC, n = 30). Median plasma-C-reactive protein concentrations (mg/L) decreased from 5 at baseline to 4 in CD (p = 0.01, n = 53) and from 5 to 4 in UC (p = 0.03, n = 34) at 156 weeks. Correspondingly, median faecal-calprotectin (µg/g) decreased from 641 to 114 in CD patients (p < 0.01, n = 26) and from 387 to 37 in UC patients (p = 0.02, n = 17).

Conclusion: VDZ demonstrated high continuation rates and was associated with improvements in clinical outcomes, HRQoL measures and inflammatory markers at 2 and 3 years after treatment initiation in this prospective national SVEAH extension study.

Registration: ENCePP registration number: EUPAS22735.

Keywords: Crohn’s disease; inflammatory bowel disease; real-world data; ulcerative colitis; vedolizumab.