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Entyvio safe, effective for refractory pouchitis
Entyvio is safe and effective for the treatment of Crohn’s disease of the pouch and chronic pouchitis, according to data published in Inflammatory Bowel Diseases.
Parakkal Deepak, MBBS, MS, of the division of gastroenterology at Washington University School of Medicine in St. Louis, and colleagues wrote that inflammation of the pouch after ileal pouch-anal anastomosis can have a significant impact on a patient’s life and be quite difficult to treat.
“Optimal treatment for pouchitis that is refractory or dependent to antibiotics is unknown,” they wrote. “The immunomodulators and biologics used to treat [CD] have been used to varying success.”
Researchers analyzed data from 83 adult patients who received the drug for endoscopic inflammation of the pouch between 2014 and 2017 to assess the effectiveness and safety of Entyvio (vedolizumab, Takeda) in CD of the pouch and chronic antibiotic-dependent or antibiotic-refractory pouchitis. Clinical response at any time served as the primary endpoint. Secondary outcomes included clinical remission, endoscopic response and remission.
After a median follow-up of 1.3 years, the proportion of patients who achieved at least a clinical response was 71.1%, and 19.3% achieved clinical remission.
Of 73 patients who completed a follow-up pouchoscopy, investigators found that 54.1% achieved endoscopic response and 17.6% achieved mucosal healing.
When they assessed the effect of different factors on clinical response, Deepak and colleagues found that patients who developed pouchitis symptoms less than 1 year after undergoing ileal pouch-anal anastomosis were less likely to respond to vedolizumab. The effect remained after they controlled for other risk factors.
“Given the good safety profile observed in our study and others, vedolizumab warrants consideration for the management of refractory pouchitis,” they wrote. “Larger prospective studies are needed to evaluate its efficacy and safety in comparison with other drug classes and identify factors associated with response.” – by Alex Young
Disclosures: Deepak reports receiving consulting fees from Janssen and Pfizer, as well as speaker fees from AbbVie and a research grant from Takeda. Please see the full study for all other authors’ relevant financial disclosures.