İnflamatuvar Barsak Hastalarında Vedolizumab Deneyimi: Tek Merkez Verileri

Year 2020, Volume: 20 Issue: 3, 169 - 173, 11.01.2022

Ayça Gökçen Değirmenci Saltürk

https://doi.org/10.17941/agd.1005038

Abstract

GİRİŞ ve AMAÇ: Vedolizumab, Ülseratif Kolit ve Crohn Hastalığı tedavisinde kullanılan barsak spesifik α4β7 integrin antagonistidir. Tumör nekroz faktör antagonistlerine cevapsız hastalarda vedolizumab tedavisi endike olup gerçek yaşam verileri ile çalışma sonuçları her zaman paralel gitmemektedir.Çalışmamızda; tümör nekroz faktör antagonist deneyimli, kliniğimizde vedolizumab ile tedavi edilmiş inflamatuvar barsak hastalarında (Crohn Hastalığı ve Ülseratif Kolit) tek merkezli, retrospektif, gerçek yaşam veri sonuçlarının değerlendirilmesini amaçladık.
YÖNTEM ve GEREÇLER: 6 aydan uzun, vedolizumab tedavisi almış 35 hasta (17 (%48,5) kadın, yaş ort. 43(22-76) ±13) çalışmaya alındı. Bu hastaların 23’ü Crohn Hastası ve 12’si Ülseratif Kolit hastasıydı. Hastaların demografik özellikleri, klinik bulguları ve 12. ayda endoskopik remisyonu, mukozasal iyilşemeleri değerlendirildi.
BULGULAR: CH hastalarının 15 (%65,2) in de endoskopik remisyon sağlanırken, 8(%34,78)’i cevapsız olarak kabul edildi. ÜK ise endoskopik remisyon ve cevapsız hasta sayısı eşitti (n=6, %50).
TARTIŞMA ve SONUÇ: Tnf alfa antagonisti deneyimli özellikle Crohn Hastaları olmak üzere inflamatuvar barsak hastalarında vedolizumab kullanımı etkin ve güvenilir olduğu gözlemlenmiştir.

Keywords

vedolizumab, ülseratif kolit, crohn hastalığı

References

• Referans1 . Peyrin-Biroulet L, Sandborn W, Sands BE et al. Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE): Determining Therapeutic Goals for Treat-to-Target. Am J Gastroenterol. 2015; 110: 1324-1338
• Referans2. Kozuch PL, Hanauer SB. Treatment of Inflammatory Bowel Disease: A Review of Medical Therapy. World J Gastroenterol .2008; 14: 354-377
• Referans3. Annese V, Duricova D, Gower-Rousseau C et al. Impact of New Treatments on Hospitalisation, Surgery, Infection, and Mortality in IBD: A Focus Paper by The Epidemiology Committee of ECCO. J Crohns Colitis. 2016; 10:216–225.
• Referans4. Garnock-Jones KP. Vedolizumab: A Review of Its Use in Adult Patients with Moderately to Severely Active Ulcerative Colitis or Crohn's disease. BioDrugs. 2015;29(1):57-67.
• Referans5. Fedyk ER, Wyant T, Yang LL et al. Exclusive Antagonism of The Alpha4 beta7 Integrin by Vedolizumab Confirms The Gut-selectivity of This Pathway in Primates. Inflamm Bowel Dis. 2012;18(11):2107-2119.
• Referans6. Soler D, Chapman T, Yang LL et al. The Binding Specificity and Selective Antagonism of Vedolizumab, an Anti-alpha4beta7 Integrin Therapeutic Antibody in Development for Inflammatory Bowel Diseases. J Pharmacol Exp Ther. 2009;330(3):864-875
• Referans7. Hesterberg PE, Winsor-Hines D, Briskin MJ et al. Rapid Resolution of Chronic Colitis in The Cotton-top Tamarin with an Antibody to a Gut-homing Integrin alpha 4 beta 7. Gastroenterology. 1996;111(5):1373-1380.
• Referans8. Sandborn WJ, Feagan BG, Rutgeerts P et al. GEMINI 2 Study Group. Vedolizumab as Induction and Maintenance Therapy for Crohn's Disease. N Engl J Med. 2013;369:711‐721.
• Referans9. Feagan BG, Rutgeerts P, Sands BE, Hanauer S, Colombel JF, Sandborn WJ, et al. GEMINI 1 Study Group. Vedolizumab as Induction and Maintenance Therapy for Ulcerative Colitis. N Engl J Med. 2013;369:699‐710.
• Referans10. Loftus EV Jr, Colombel JF, Feagan BG et al. Long‐term Efficacy of Vedolizumab for Ulcerative Colitis. J Crohns Colitis. 2017;11:400‐411.
• Referans11. Vermeire S, Loftus EV Jr, Colombel JF et al. Long‐term Efficacy of Vedolizumab for Crohn's Disease. J Crohns Colitis. 2017;11:412‐424
• Referans12. Amiot A, Serrero M, Peyrin-Biroulet L, OBSERVIBD study group and the GETAID. One-year Effectiveness and Safety of Vedolizumab Therapy for Inflammatory Bowel Disease: a Prospective Multicentre Cohort Study. Aliment Pharmacol Ther 2017; 46: 310-321
• Referans13. Eriksson C, Marsal J, Bergemalm D et al. SWIBREG Vedolizumab Study Group. Long-term Effectiveness of Vedolizumab in Inflammatory Bowel Disease: a National Study Based on the Swedish National Quality Registry for Inflammatory Bowel Disease (SWIBREG). Scand J Gastroenterol 2017; 52: 722-729
• Referans14. Kopylov U, Avni-Biron I, Ron Y, et al. Effectiviness and Safety of Vedolizumab for Maintenance Treatment in Inflammatory Bowel Disease-the Israeli Real World Experience. Dig. Liver Dis 2018;51:68-74.
• Referans15. Vivio EE, Kanuri N, Gilbertsen JJ et al.Vedolizumab Effectiveness and Safety Over the First Year of Use in an IBD Clinical Practice. J Crohns Colitis 2016; 10: 402-409
• Referans16.Dulai PS, Singh S, Jiang X et al. The Real World Effectiveness and Safety of Vedolizumab for Moderate-severe Crohn’s Disease:Results from the US VİCTORY Consortium.The American Journal of Gastroenterology 2016;111(8), 1147-1155.
• Referans17. Narula N, Peerani F and Meserve J. Vedolizumab for Ulcerative Colitis:Treatment outcomes from the VİTORY Consortium.Am J Gastroenterolo.2018; 113(99:1345)
• Referans18. Colombel JF, Sands BE, Rutgeerts P et al.The Safety of Vedolizumab for Ulcerative Colitis and Crohn’s Disease. Gut 2017;66:839–851.
• Referans19. Siew C Ng, Hilmi I N, Blake A et al.Low Frequency of Opportunistic Infections in Patients Receiving Vedolizumab in Clinical Trials and Post-Marketing Setting. Inflamm Bowel Dis. 2018 Nov; 24(11): 2431–2441.