First experience of vedolizumab in paediatric IBD patients

Česká verzia

Authors: Bronský J.; Hradský O.
Authors place of work: Pediatrická klinika 2. LF UK a FN Motol, Praha
Published in the journal: Gastroent Hepatol 2019; 73(3): 233-238
Category: IDB: Original Article
doi: https://doi.org/10.14735/amgh2019csgh.info01

Summary

Introduction: The humanised monoclonal anti-integrin antibody vedolizumab (VDZ) is approved for treatment of both Crohn’s disease (CD) and ulcerative colitis (UC) in adults. However, only retrospective data have been published for paediatric patients, mainly those in whom both conventional and anti-tumour necrosis factor treatment previously failed. Our study aimed to describe all paediatric patients treated with VDZ at our department since this drug became available.

Methods: We retrospectively evaluated both clinical and laboratory data (blood count, C-reactive protein (CRP) concentration and faecal calprotectin (CPT) concentration) of all patients (three with UC and three with CD) previously treated with VDZ at our department. Using a generalised linear mixed model, we searched for associations between VDZ treatment and laboratory markers.

Results: In the model including all patients, VDZ treatment was independently associated with a higher level of haemoglobin (OR 1.018; 95% CI 1.002–1.034) and had a borderline association with a lower level of thrombocytes. In the model including only patients with CD, there was a borderline association between VDZ treatment and a lower level of thrombocytes. In the model including only patients with UC, there were associations between VDZ treatment and the concentrations of CPT (OR 0.572; 95% CI 0.348–0.939), CRP (OR 0.917; 95% CI 0.868–0.969) and haemoglobin (OR 1.071; 95% CI 1.04–1.103).

Discussion: The associations between VDZ treatment and markers of disease activity found in our group of patients are in accordance with previously published data both in adults and a larger group of paediatric patients (N = 64). In that previous study, the authors reported that the CPT concentration significantly decreases during VDZ treatment in patients with UC and tends to decrease in patients with CD.

Conclusion: This study reports our first experience of treating paediatric patients with VDZ at our centre. Despite the relatively small number of patients, we demonstrated an independent association between VDZ treatment and improvement of laboratory markers of disease activity, especially in patients with UC.

Keywords:

vedolizumab – Crohn’s disease, pediatric – ulcerative colitis, pediatric – inflammatory bowel disase

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