Background: GEMINI trials demonstrated the therapeutic efficacy of vedolizumab (VDZ)
in Crohn's disease (CD) and ulcerative colitis (UC).Research design and methods: Aim
of this study was to determine the real-life effectiveness of VDZ on endoscopic healing
in the Hungarian nationwide cohort of inflammatory bowel disease (IBD) patients based
on changes on clinical and endoscopic scores. Every adult IBD patient in the country
(121 UC and 83 CD) who completed short-term VDZ therapy were enrolled, of which 72
UC and 52 CD patients could complete the long-term therapy.Results: Rates of endoscopic
healing were substantially higher in UC compared with CD patients during short- and
long-term therapy (52.9% vs. 21.7%, p<0.0001, and 51.4% vs. 21.2%, p=0.015, respectively).
In CD, the rate of endoscopic healing was lower at week 14 compared with week 22 (14.5%
vs. 37.0%, p=0.026). Prior anti-TNF-alpha therapy (88.73%) was not associated with
a significant decrease in therapeutic response. Average disease duration was significantly
lower in CD patients achieving endoscopic healing at week 52 (11.75 vs. 5.27 years,
p=0.007).Conclusions: VDZ therapy is an effective therapeutic option in anti-TNF-alpha
refractory IBD. However, endoscopic healing rate was substantially lower and showed
a significant delay in CD compared with UC.
