Extent of Mucosal Inflammation in Ulcerative Colitis Influences the Clinical Remission Induced by Vedolizumab

Scarozza P, Marafini I, Laudisi F, Troncone E, Schmitt H, Lenti MV, Costa S, Rocchetti I, De Cristofaro E, Salvatori S, Frezzati L, Di Sabatino A, Atreya R, Neurath M, Calabrese E, Monteleone G (2020)

Publication Type: Journal article

Publication year: 2020

Journal

Journal of Clinical Medicine MDPI

Book Volume: 9

Journal Issue: 2

DOI: 10.3390/jcm9020385

Abstract

Randomized controlled clinical trials and real-life observations indicate that less than 50% of patients with Crohn's disease (CD) or ulcerative colitis (UC) respond to vedolizumab, a humanized monoclonal antibody that blocks the alpha 4 beta 7 integrin. Since alpha 4 beta 7-expressing lymphocytes mainly infiltrate the left colon, we assessed whether localization of CD and UC influences vedolizumab-induced remission. One hundred and eighty-one patients (74 CD and 107 UC) receiving vedolizumab in 3 referral centers were retrospectively evaluated for clinical remission at week 14. Demographic and clinical characteristics were compared between remitters and non-responders, and multivariable multinomial analysis was performed to identify predictors of remission. Remission was achieved in 17 CD (23%) and 34 UC (32%) patients, respectively. In CD, localization of the lesions did not influence clinical remission. In UC, the remitters had more frequently a distal/left-sided colitis (21/34, 62%) as compared to the non-responders (9/47, 19%), and extensive colitis was more frequent in the non-responders (38/47, 81%) than in the remitters (13/34, 38%). The multivariable multinomial analysis showed that distal/left-sided colitis was associated with a higher probability of clinical remission while extensive colitis was inversely associated with induction of remission. Data indicate that UC patients with distal or left-sided colitis are more likely to achieve remission than patients with extensive colitis following vedolizumab treatment.

Authors with CRIS profile

Heike Knott Department of Medicine 1 – Gastroenterology, Pneumology and Endocrinology Raja Atreya Professur für Translationale Immunforschung bei chronisch entzündlichen Darmerkrankungen (Heisenberg-Professur) Markus Neurath Lehrstuhl für Innere Medizin I

Involved external institutions

Università degli Studi di Roma 'Tor Vergata' IT Italy (IT) Università degli Studi di Pavia IT Italy (IT) High Council of the Judiciary (Italy) IT Italy (IT)

How to cite

APA:

Scarozza, P., Marafini, I., Laudisi, F., Troncone, E., Schmitt, H., Lenti, M.V.,... Monteleone, G. (2020). Extent of Mucosal Inflammation in Ulcerative Colitis Influences the Clinical Remission Induced by Vedolizumab. Journal of Clinical Medicine, 9(2). https://doi.org/10.3390/jcm9020385

MLA:

Scarozza, Patrizio, et al. "Extent of Mucosal Inflammation in Ulcerative Colitis Influences the Clinical Remission Induced by Vedolizumab." Journal of Clinical Medicine 9.2 (2020).

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