P644 Effectiveness of vedolizumab on intestinal outcomes and articular manifestations: Real-world data from the Sicilian Network for inflammatory bowel disease (SN-IBD). (16th January 2018) - Macaluso, F S
Abstract: Background: Vedolizumab (VDZ) is a biologic agent approved for the treatment of adult patients with moderately to severely active ulcerative colitis (UC) or Crohn's disease (CD). The effectiveness of the drug in real-world practice is currently under evaluation, while its role in cases of inflammatory bowel disease-associated spondyloarthritis is still unclear. Methods: Web-based data from the cohort of the Sicilian Network for inflammatory bowel disease (SN-IBD) – a group composed by all Sicilian centres prescribing biologics – were extracted to perform a multicentre observational study on the effectiveness of VDZ on intestinal and articular symptoms after 10 and 22 weeks of treatment. Results: From July 2016 to April 2017, 163 patients (84 with CD and 79 with UC) were included. At Week 10, a steroid-free remission was obtained in 71 patients (43.6%), and a clinical response in 37 (22.7%). At Week 22, 40.8% of patients were in steroid-free remission, and 14.1% showed a clinical response (Figure 1). At multiple logistic regression analysis, a longer duration of disease (OR 0.961, p = 0.047) and the presence of steroid dependence (OR 0.189, p = 0.033) were predictors of reduced rates of clinical benefit at Week 10, while a low serum level of C-reactive protein at baseline (OR 0.950, p = 0.031) predicted clinical benefit at Week 22. An improvement on articular symptoms was reported in 39.5% of patients with active spondyloarthritis at baseline after 10 weeks, and in 45.4% of patients at Week 22 (Figure 2). The only factor associated with articular response was the coexistence of clinical benefit on intestinal symptoms (at Week 10: OR 8.471, p = 0.05; at Week 22: OR 5.600, p = 0.08). Conclusions: In our large cohort of Sicilian IBD patients, VDZ showed good effectiveness after 10 and 22 weeks of treatment, particularly in those with limited inflammatory burden. A subset of patients reported improvement on articular symptoms, probably as a consequence of the concomitant control of gut inflammation.