Evaluation of the Optimal Position for Vedolizumab in the Japanese Treatment Paradigm for Ulcerative Colitis Using Markov Modeling. Issue 2 (18th March 2020)

• Record Type: Journal Article
• Authors: Uda, Akihito; Eto, Yuki; Li, Yuxin; Matsuda, Hiroyuki; Demiya, Sven; Watanabe, Tomoyuki; Ota, Mihoko; Iwakiri, Ryuichi; Igarashi, Ataru
• Is Part Of: Crohn's & colitis 360. Volume 2:Issue 2(2020)
• Publication Date: 2020-03-18
• Subjects: biologic therapy -- Japan -- Markov process -- ulcerative colitis -- vedolizumab; Crohn's disease -- Periodicals; Colitis -- Periodicals; 616.344
• DOI: 10.1093/crocol/otaa017
• Languages: English
• ISSNs: 2631-827X

Abstract

Abstract: Background: This analysis assessed the optimal position of vedolizumab for Japanese patients with ulcerative colitis. Methods: A Markov model was used to evaluate the performance of 4 treatment algorithms of vedolizumab position: after azathioprine (Algorithm 1); after tacrolimus/cytapheresis (Algorithm 2); after a first anti-tumor necrosis factor alpha (anti-TNFα) (Algorithm 3); and after a second anti-TNFα before colectomy (Algorithm 4). Results: Algorithm 1 was the dominant strategy, with an incremental benefit over the other algorithms of 0.028–0.031 quality-adjusted life years. Conclusions: This simulation predicts that introducing vedolizumab immediately after a thiopurine and before other therapies will provide most benefit. Lay Summary: Our Markov simulation analysis predicts that introducing vedolizumab immediately after a thiopurine and before other therapies will provide the most benefit and should be considered for patients with steroid-dependent, moderate-to-severely active ulcerative colitis.