The following article is a part of conference coverage from the Advances in Inflammatory Bowel Diseases 2021 Annual Meeting , held from December 9 to 11, 2021. The team at Gastroenterology Advisor will be reporting on the latest news and research conducted by leading experts in gastroenterology. Check back for more from AIBD 2021.

 

Early treatment of inflammatory bowel disease (IBD) with vedolizumab (VDZ) is low, with patients more likely to be women and of younger age, according to research presented at the Advances in Inflammatory Bowel Diseases (AIBD) 2021 Annual Meeting, held from December 9 to 11, 2021, in Orlando, Florida and virtually.


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While data demonstrate that earlier use of biologics in IBD is associated with greater response and remission, in reality, biologic treatment is often delayed, thereby limiting its effectiveness and increasing adverse outcomes. Further assessment of factors that contribute to therapy choice is needed.

Researchers conducted a real-world assessment by examining administrative datasets from 2017 to 2019 in VDZ-treated patients with Crohn disease (CD) or ulcerative colitis (UC). They identified 5 predefined treatment pathways: early VDZ  (VDZ within 30 days of first IBD diagnostic claim), delayed VDZ 1 (immunomodulators and then switched to VDZ), delayed VDZ 2 (corticosteroids with immunomodulators prior to VDZ), delayed VDZ 3 (5-Aminosalicylic acid [ASA] with corticosteroids prior to VDZ), or delayed VDZ 4 (5-ASA with corticosteroids and immunomodulators prior to VDZ).

The researchers identified 1342 patients with UC and 964 patients with CD that received VDZ. Among patients with UC, the median age was 40 vs 44 years and proportions of men were 46.1% vs 51.4% in the early VDZ vs delayed VDZ cohorts, respectively. Among patients with CD, the median age was 43 vs 45 years and proportions of men were 39.8%% vs 43.9% in the early VDZ vs delayed VDZ cohorts, respectively.

The proportion of patients with UC receiving early VDZ, delayed VDZ 1, delayed VDZ 2, delayed VDZ 3, and delayed VDZ 4 were 6.6%, 7.5%, 14.8%, 37.6%, and 33.4%, respectively. The proportion of patients with CD receiving early VDZ, delayed VDZ 1, delayed VDZ 2, delayed VDZ 3, and delayed VDZ 4 were 9.6%, 19.0%, 36.8%, 19.0%, 15.6%, respectively.

For both indications, no meaningful differences between treatment groups were observed by geographic region, payor type, or year of diagnosis.

“In this administrative real-world dataset, fewer than 10% of patients with IBD were treated with VDZ within 30 days of diagnosis, and these patients were more likely to be younger and women,” concluded the researchers. These findings differ from current guidelines which suggest VDZ may be introduced earlier, “preferentially in older patients at higher risk for infection.”

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Reference

Kuharic M, Krugliak CN, Candela N, et al. Early versus later use of vedolizumab in IBD: patient characteristics and treatment patterns in the real world (RALEE). Presented at: AIBD 2021 Annual Meeting; December 9-11, 2021; Orlando, FL and virtual. Abstract P042.