Early response to vedolizumab linked to week 52 remission in ulcerative colitis

Patients with ulcerative colitis (UC) who achieve early partial Mayo score (PMS) remission with vedolizumab are more likely to attain week 52 remission than delayed responders, suggests a study.

A group of researchers performed a post hoc analysis of the VARSITY study and compared patients with early PMS (PMS ≤1 at week 4/6 of therapy) to those with delayed PMS remission (PMS ≤1 at week 14 and not week 4/6 of therapy).

The research team assessed the differences in proportions of patients achieving week 52 clinical remission (PMS=0), endoscopic improvement (Mayo endoscopic subscore ≤1), and histoendoscopic mucosal improvement (HEMI; Mayo endoscopic subscore ≤1 and Geboes score highest grade <3.2). They also adjusted for confounders using multivariate logistic regression.

Among eligible participants, 147 vedolizumab-treated and 110 adalimumab-treated individuals achieved early or late PMS remission. UC patients who attained early PMS remission with vedolizumab had greater odds of achieving week 52 clinical remission than those with delayed PMS remission with vedolizumab (69.1 percent vs 50.0 percent; adjusted odds ratio [aOR], 2.43, 95 percent confidence interval [CI], 1.11‒5.33; p=0.027).

Furthermore, week 52 HEMI was more likely among UC patients with early PMS remission with vedolizumab (63.9 percent vs 40.0 percent; aOR, 2.60, 95 percent CI, 1.20‒5.62; p=0.015), while week 52 endoscopic improvement was comparable between individuals with early and delayed PMS remission with vedolizumab.

Notably, no differences were seen in clinical remission, endoscopic improvement, and HEMI between patients with early and delayed PMS remission with adalimumab.