Crohns & Colitis Congress

Crohns & Colitis Congress

Source:

Cleveland NK, et al. Early versus delayed initiation of vedolizumab in ulcerative colitis: Treatment response in the real world (RALEE). Presented at: Crohn’s and Colitis Congress; Jan. 20-22, 2022 (virtual).

Disclosures: Cleveland reports consulting for Takeda Pharmaceuticals.
January 22, 2022
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Starting Entyvio within ‘30 days of diagnosis’ improved treatment response in UC

Source:

Cleveland NK, et al. Early versus delayed initiation of vedolizumab in ulcerative colitis: Treatment response in the real world (RALEE). Presented at: Crohn’s and Colitis Congress; Jan. 20-22, 2022 (virtual).

Disclosures: Cleveland reports consulting for Takeda Pharmaceuticals.
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Patients with ulcerative colitis were more likely to respond to therapy if started on Entyvio within 30 days of diagnosis rather than if delayed by other initial treatments, according to a presenter at the Crohn’s and Colitis Congress.

“Patients with newly diagnosed ulcerative colitis are often prescribed corticosteroids, immunomodulators and [5-aminosalicylic acid],” Noa Krugliak Cleveland, MD, clinical instructor at The University of Chicago Medicine, told attendees. “Delayed initiation of biologic therapy may increase complications and consequent cost. However, data are lacking on the effects of early biologic therapy in patients with ulcerative colitis. The RALEE study aimed to investigate the effect of early vs. delayed initiation of vedolizumab on treatment outcomes and medical costs.”

Cleveland and colleagues used the MarketScan Commercial Claims and Encounters database and the MarketScan Medicare Supplemental database to identify 136,315 adult patients with UC who had more than one claim for Entyvio (vedolizumab, Takeda) and continuous enrollment for more than 12 months before and after their initial UC diagnosis.

Noa Krugliak Cleveland

The researchers categorized 1,342 eligible patients into one of five post-diagnosis treatment pathways:

  • Early vedolizumab group: Vedolizumab within 30 days of initial UC diagnosis;
  • Delayed vedolizumab group 1: Immunomodulators prior to vedolizumab;
  • Delayed vedolizumab group 2: Corticosteroids with immunomodulators prior to vedolizumab;
  • Delayed vedolizumab group 3: 5ASAs with corticosteroids prior to vedolizumab; and
  • Delayed vedolizumab group 4: 5ASAs with corticosteroids and immunomodulators prior to vedolizumab.

The researchers defined response as no new concomitant use of corticosteroids, no IBD-related surgery, no increased administration of vedolizumab and no treatment discontinuation or treatment switch within 60 days after starting vedolizumab.

Cleveland and colleagues reported that, compared with any of the delayed vedolizumab treatments groups, patients who received early vedolizumab had a significantly higher likelihood of response. In addition, the proportion of patients with response to vedolizumab was higher for early vedolizumab (88.8%) vs. those in the delayed vedolizumab groups (70.1–79.8%).

“Patients with ulcerative colitis are more likely to respond treatment if vedolizumab is initiated within 30 days after diagnosis than if delayed after initiation of corticosteroids, immunomodulators and 5ASAs,” Cleveland said. “These findings are consistent with clinical guidelines that recommend use of vedolizumab for induction of remission in patients with moderately-to-severely active ulcerative colitis. Further analyses of remission, health care resource utilization and associated medical costs are underway.”