Kobayashi Taku, Hisamatsu Tadakazu, Motoya Satoshi, Fujii Toshimitsu, Kunisaki Reiko, Shibuya Tomoyoshi, Matsuura Minoru, Takeuchi Ken, Hiraoka Sakiko, Yasuda Hiroshi, Yokoyama Kaoru, Takatsu Noritaka, Maemoto Atsuo, Tahara Toshiyuki, Tominaga Keiichi, Shimada Masaaki, Kuno Nobuaki, Fernandez Jovelle L, Ishiguro Kaori, Cavaliere Mary, Deguchi Hisato, Hibi Toshifumi
Center for Advanced IBD Research and Treatment, Kitasato University Kitasato Institute Hospital, Tokyo, Japan.
Department of Gastroenterology and Hepatology, Kyorin University School of Medicine, Tokyo, Japan.
Intest Res. 2025 Jan 16. doi: 10.5217/ir.2024.00063.
BACKGROUND/AIMS: The objectives of this real-world study were to determine 1-year persistence with vedolizumab in patients with ulcerative colitis and to evaluate factors contributing to loss of response.
In this multicenter, retrospective, observational chart review, patients with moderately to severely active ulcerative colitis who received ≥ 1 dose of vedolizumab in clinical practice at 16 tertiary hospitals in Japan (from December 2018 through February 2020) were enrolled.
Persistence with vedolizumab was 64.5% (n = 370); the median follow-up time was 53.2 weeks. Discontinuation due to loss of response among initial clinical remitters was reported in 12.5% (35/281) of patients. Multivariate analysis showed that concomitant use of tacrolimus (odds ratio [OR], 2.76; 95% confidence interval [CI], 1.00-7.62; P= 0.050) and shorter disease duration (OR for median duration ≥ 7.8 years vs. < 7.8 years, 0.33; 95% CI, 0.13-0.82; P= 0.017) were associated with discontinuation due to loss of response. Loss of response was not associated with prior use of anti-tumor necrosis factor alpha therapy, age at the time of treatment, disease severity, or concomitant corticosteroids or immunomodulators. Of the 25 patients with disease duration < 1 year, 32.0% discontinued due to loss of response.
Persistence with vedolizumab was consistent with previous reports. Use of tacrolimus and shorter disease duration were the main predictors of decreased persistence.
