Vedolizumab infusion to jab switcy feasible in maintenance treatment of IBD

Patients with inflammatory bowel disease (IBD) can switch from intravenous to subcutaneous vedolizumab treatment in the maintenance setting, with the clinical and biochemical disease activity remaining stable after the change, as shown in a study. However, some patients are switched back to intravenous treatment due to adverse events (AEs) or fear of needles.

Researchers evaluated the effectiveness, safety, and pharmacokinetics of a switch from intravenous to subcutaneous maintenance vedolizumab treatment in 135 IBD patients, of whom 82 had Crohn’s disease (CD) and 53 had ulcerative colitis (UC). All patients had received ≥4 months intravenous vedolizumab.

The outcomes evaluated in this study included the time to discontinuation of vedolizumab jabs, AEs, changes in clinical and biochemical outcomes, and vedolizumab concentrations at baseline, and weeks 12 and 24.

At a median of 6 and 18 weeks following subcutaneous therapy initiation, five (9.4 percent) UC patients and 11 (13.4 percent) CD patients, respectively, discontinued treatment. Four patients (all of whom had CD) switched to a different drug due to loss of response, whereas nine and three patients switched back to intravenous vedolizumab due to AEs and needle fear, respectively. The most common AEs were injection site reactions (n=15) and headache (n=6).

Meanwhile, there was no significant change noted in the median clinical and biochemical disease activity. Median vedolizumab serum concentrations jumped from 19 μg/ml at the time of the switch to 31 μg/ml 12 weeks after the switch (p<0.005).

The finding of a significant increase in serum vedolizumab concentrations after switching from intravenous to subcutaneous therapy warrants a dose interval extension study.