Abstract

Vedolizumab as the first line of biologic therapy for ulcerative colitis and Crohn's disease - a systematic review with meta-analysis

Dig Liver Dis. 2022 Sep;54(9):1168-1178. doi: 10.1016/j.dld.2021.11.014.Epub 2021 Dec 10.

 

Mohamed Attauabi 1Gorm Roager Madsen 2Flemming Bendtsen 2Jakob Benedict Seidelin 3Johan Burisch 2

 
     

Author information

1Department of Gastroenterology and Hepatology, Herlev Hospital, University of Copenhagen, Borgmester Ib Juuls Vej 1, 2730 Denmark; Gastrounit, Medical Section, Hvidovre University Hospital, Hvidovre, Kettegaard Alle 30, 2650 Denmark; Copenhagen Center for Inflammatory Bowel Disease in Children, Adolescents and Adults, University of Copenhagen, Hvidovre Hospital, Hvidovre, Kettegaard Alle 30, 2650 Denmark. Electronic address: mohamed.attauabi.01@regionh.dk.

2Gastrounit, Medical Section, Hvidovre University Hospital, Hvidovre, Kettegaard Alle 30, 2650 Denmark; Copenhagen Center for Inflammatory Bowel Disease in Children, Adolescents and Adults, University of Copenhagen, Hvidovre Hospital, Hvidovre, Kettegaard Alle 30, 2650 Denmark.

3Department of Gastroenterology and Hepatology, Herlev Hospital, University of Copenhagen, Borgmester Ib Juuls Vej 1, 2730 Denmark.

Abstract

Background: The efficacy and safety of vedolizumab in bio-naïve patients with ulcerative colitis (UC) and Crohn's disease (CD) remain unknown.

Aims: To perform a meta-analysis regarding vedolizumab as first line of biological therapy for UC or CD.

Methods: A systematic review of Medline, EMBASE, and Cochrane databases per December 2020 was undertaken. Meta-analysis was conducted using random-effects models.

Results: This systematic review identified 79 eligible studies with 4,520 and 3,494 bio-naïve patients with UC and CD, respectively, and 8,105 and 11,140 bio-exposed patients. Among bio-naïve patients with UC, a total of 40.0% (95%CI 27.0-54.0, I2=86%) and 63.9% (95%CI 47.0-79.2, I2=36%) achieved clinical remission at weeks 14 and 52, respectively. The corresponding rates in CD were 54.0% (95%CI 42.0-66.0, I2=23%), and 61.7% (95%CI 55.2-68.1, I2=0%). Bio-naïvety was associated with a higher probability of clinical remission at week 52 in UC (relative risk (RR)=1.32 (95%CI 1.14-1.53)), while this was only apparent until week 26 in CD (RR=1.60 (95%CI 1.30-1.95)). Finally, bio-naïve UC patients had a lower risk of serious adverse events (RR=0.29 (95%CI 0.09-0.95)).

Conclusion: Vedolizumab was found to have a favorable efficacy and safety profile in bio-naïve patients with UC and CD. The findings have implications in the management of IBD.

 

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