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Katharina Gröhl

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Hüttemann E, Muzalyova A, Gröhl K, Nagl S, Fleischmann C, Ebigbo A, Classen J, Wanzl J, Prinz F, Mayr P, Schnoy E. Efficacy and Safety of Vedolizumab in Patients with Inflammatory Bowel Disease in Association with Vedolizumab Drug Levels. J Clin Med 2023;13:140. [PMID: 38202147 PMCID: PMC10779856 DOI: 10.3390/jcm13010140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 12/04/2023] [Accepted: 12/19/2023] [Indexed: 01/12/2024] Open

Abstract

BACKGROUND

Vedolizumab (VDZ) is a well-established and important therapeutic option in the treatment of patients with inflammatory bowel disease (IBD). However, the significance of therapeutic drug monitoring (TDM) with VDZ remains a contradictory field in daily clinical practice. Our study aims to clarify the predictive impact of VDZ drug levels in long-term clinical outcomes in a real-world cohort.

METHODS

Patients with moderate to severe ulcerative colitis (UC) and Crohn's disease (CD) from a tertiary IBD referral center at the University Hospital Augsburg, Germany, were enrolled in this single-center retrospective data analysis. Clinical and endoscopic data were collected at month 6, month 12, and at the last time of follow-up, and outcomes were correlated with VDZ levels at week 6.

RESULTS

This study included 95 patients, 68.4% (n = 65) with UC, 24.2% (n = 23) with CD, and 7.4% (n = 7) with indeterminate colitis (CI). Patients with a mean VDZ treatment time of 17.83 months ± 14.56 showed clinical response in 29.5% (n = 28) and clinical remission in 45.3% (n = 43) at the end of the study. Endoscopic response occurred in 20.0% (n = 19) and endoscopic remission in 29.5% (n = 28) at the end of the study. The sustained beneficial effect of VDZ was also reflected in a significant change in biomarker levels. VDZ trough level at week 6 was determined in 48.4% (n = 46) with a mean of 41.79 µg/mL ± 24.58. A significant association between VDZ level at week 6 and both short and long-term outcomes could not be demonstrated. However, numerically higher VDZ levels were seen in patients with endoscopic and clinical improvement at month 6 and at the time of last follow-up.

CONCLUSIONS

This study demonstrated efficacy and safety for VDZ in a real-world cohort. Although, for some parameters, a clear trend for higher VDZ levels at week 6 was seen, the efficacy of VDZ was not significantly correlated to VDZ level at week 6, which questions the predictive value of VDZ levels in the real world.

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Affiliation(s)

Eva Hüttemann Internal Medicine III, University Hospital Augsburg, 86156 Augsburg, Germany; (A.M.); (K.G.); (S.N.); (C.F.); (A.E.); (J.C.); (J.W.); (F.P.) Internal Medicine, Kantonsspital St. Gallen, 9007 St. Gallen, Switzerland
Anna Muzalyova Internal Medicine III, University Hospital Augsburg, 86156 Augsburg, Germany; (A.M.); (K.G.); (S.N.); (C.F.); (A.E.); (J.C.); (J.W.); (F.P.)
Katharina Gröhl Internal Medicine III, University Hospital Augsburg, 86156 Augsburg, Germany; (A.M.); (K.G.); (S.N.); (C.F.); (A.E.); (J.C.); (J.W.); (F.P.)
Sandra Nagl Internal Medicine III, University Hospital Augsburg, 86156 Augsburg, Germany; (A.M.); (K.G.); (S.N.); (C.F.); (A.E.); (J.C.); (J.W.); (F.P.)
Carola Fleischmann Internal Medicine III, University Hospital Augsburg, 86156 Augsburg, Germany; (A.M.); (K.G.); (S.N.); (C.F.); (A.E.); (J.C.); (J.W.); (F.P.) Department of Gastroenterology, Hepatology and Endocrinology, Klinikum Nürnberg, 90419 Nuremberg, Germany
Alanna Ebigbo Internal Medicine III, University Hospital Augsburg, 86156 Augsburg, Germany; (A.M.); (K.G.); (S.N.); (C.F.); (A.E.); (J.C.); (J.W.); (F.P.)
Johanna Classen Internal Medicine III, University Hospital Augsburg, 86156 Augsburg, Germany; (A.M.); (K.G.); (S.N.); (C.F.); (A.E.); (J.C.); (J.W.); (F.P.)
Julia Wanzl Internal Medicine III, University Hospital Augsburg, 86156 Augsburg, Germany; (A.M.); (K.G.); (S.N.); (C.F.); (A.E.); (J.C.); (J.W.); (F.P.)
Friederike Prinz Internal Medicine III, University Hospital Augsburg, 86156 Augsburg, Germany; (A.M.); (K.G.); (S.N.); (C.F.); (A.E.); (J.C.); (J.W.); (F.P.)
Patrick Mayr Internal Medicine II, University Hospital Augsburg, 86156 Augsburg, Germany; Department of Oncology and Hematology, Kantonsspital St. Gallen, 9007 St. Gallen, Switzerland
Elisabeth Schnoy Internal Medicine III, University Hospital Augsburg, 86156 Augsburg, Germany; (A.M.); (K.G.); (S.N.); (C.F.); (A.E.); (J.C.); (J.W.); (F.P.)

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