Entyvio may improve disease course in patients with immune-mediated diarrhea colitis
Click Here to Manage Email Alerts
Entyvio therapy may improve disease course of immune-mediated diarrhea colitis and decrease steroid exposure, according to a presentation at the American College of Gastroenterology virtual annual meeting.”
“Our conclusions [show] compared to infliximab, long-term use of vedolizumab has equal efficacy in clinical remission, slight delay to symptom response, better IMDC disease course, lower IMDC recurrence, less cancer progression and better survival rate over 40 months,” Yinghong Wang, MD, PhD, assistant professor at The University of Texas MD Anderson Cancer Center, said during her presentation.
Wang and colleagues performed a retrospective study of 150 patients with immune-mediated diarrhea colitis who had received selective immunosuppressive therapy. Sixty-one patients received only Entyvio (vedolizumab, Takeda), 71 patients received only Remicade (infliximab, Janssen) and 18 patients received both. Investigators analyzed patient demographics, clinical variables and overall survival data.
Genitourinary cancer and melanoma were the most observed cancer types. Patients who received vedolizumab alone had shorter steroid treatment compared with infliximab alone (35 vs. 50 days; P < .001). Further, patients who received vedolizumab had less steroid tapering attempts (1 vs. 2; P < .001) and shorter duration of hospital stay (11 vs. 14 days; P = .025).
“Vedolizumab was often administered [three or more] doses, while infliximab was mostly limited to [one to two] doses (P < .001),” Wang said.
She reported clinical remission of immune-mediated diarrhea colitis was similar between groups at 88%. The vedolizumab group had significantly lower immune-mediated diarrhea colitis recurrence (13% vs. 28%; P = .018) than infliximab. However, the vedolizumab group had a delay in clinical response (17 vs. 10 days; P = .003).
Longer duration of ICI treatment (P = .018), colitis symptoms (P = .025) and steroid use (P = .035) were among the factors correlated with higher immune-mediated diarrhea colitis recurrence. Delayed introduction to selective immunosuppressive therapy and infliximab use alone were also correlated with immune-mediated diarrhea colitis recurrence.
According to Wang, multiple doses of selective immunosuppressive therapy were significantly correlated with lower immune-mediated diarrhea colitis recurrence (P = .032). Favorable overall survival factors included vedolizumab alone (P = .042), higher doses of selective immunosuppressive therapy (P = .026) and less steroid tapering attempts (P = .019).
“As expected, more steroids [in a] treatment course were also associated with worse survival compared with less steroids [in a] treatment course,” Wang said.
Collapse
Wang Y, et al. Abstract: S0137. Presented at the American College of Gastroenterology Annual Scientific Meeting (Virtual). Oct. 23-28, 2020.
Read more about
Click Here to Manage Email Alerts