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Systematic Literature Review and Meta-analysis: Real-World Mucosal Healing in Vedolizumab-Treated Patients with Crohn’s Disease

Authors :
Silvio Danese
Pravin Kamble
Jin Yang
Jean-Gabriel Le Moine
Shahnaz Khan
Emma Hawe
Christian Agboton
Song Wang
Peter M. Irving
Source :
GastroHep. 2022:1-12
Publication Year :
2022
Publisher :
Hindawi Limited, 2022.

Abstract

Background. Vedolizumab is a gut-selective monoclonal anti-α4β7-integrin antibody approved for the treatment of adults with moderately to severely active Crohn’s disease (CD). Aim. To conduct a systematic literature review and meta-analysis of published real-world studies examining mucosal healing (MH) rates in patients with CD treated with vedolizumab in routine clinical practice. Methods. MEDLINE-, Cochrane-, and EMBASE-indexed publications from January 2014 to January 2020 and 2018-2019 conference abstracts were searched for real-world studies reporting MH-related outcomes in vedolizumab-treated adults with CD. A meta-analysis was conducted in R to generate pooled estimates of MH. The primary analysis included studies reporting point estimates of MH/endoscopic remission as absence of ulcers/erosions and/or Simple Endoscopic Score for CD (SES-CD) cut − points < 4 , at 6 and 12 months. Results. The systematic literature review included 36 studies, predominantly of antitumour necrosis factor-experienced patients. MH and endoscopic remission were the most frequently reported endpoints. MH rates were 10.1%-46.0% at 6 months (ten studies) and 21.2%-62.5% at 12 months (eight studies). Fifteen studies defining MH as absence of ulcers/erosions and/or SES-CD cut − points < 4 were included for meta-analysis. Pooled MH rates for the primary analysis were 31.8% at 6 months (95% confidence interval (CI): 25.6-38.3; five studies, N = 223 ) and 33.4% at 12 months (95% CI: 25.9-41.4; three studies, N = 151 ). Conclusion. Approximately one-third of vedolizumab-treated patients with CD achieved MH at both 6 and 12 months in real-world clinical settings, despite utilisation in largely biologic-refractory patients. These findings confirm the effectiveness of vedolizumab for achieving MH in patients with CD.

Details

ISSN :
14781239
Volume :
2022
Database :
OpenAIRE
Journal :
GastroHep
Accession number :
edsair.doi...........54145b4e6d7cb70a677ccc4d5076816a
Full Text :
https://doi.org/10.1155/2022/6975416