P207 - CLINICAL PREDICTORS OF RESPONSE TO VEDOLIZUMAB TREATMENT IN CROHN’S DISEASE
19 Jan 18
5:30 PM
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7:00 PM
Background: Vedolizumab (VDZ) is a monoclonal antibody to alpha4 beta7 integrin that is approved as first line therapy for Crohn’s Disease (CD). Much like other biologics, the efficacy of VDZ in treating CD can vary among patients in clinical practice. The aim of this study was to determine predictors of response to VDZ therapy in CD. Methods: Subjects treated with VDZ between 2013 and 2017 at the University of Iowa Hospitals and Clinics were identified in the electronic health record. Those who met inclusion criteria had serologic, clinical and endoscopic data extracted at the time of treatment initiation, 8-12 week follow-up and 6-12 months follow-up. Subjects were categorized as responders and non-responders based on clinical activity impressions, Harvey Bradshaw Index, and endoscopic data. This data was then analyzed using stepwise regression with forward selection. Results: 45 patients were followed through to 12-month follow-up from initiation. Among the 45 patients, 23/45 (51.1%) achieved clinical and endoscopic remission, 13/45 (28.8%) had partial response and 9/45 (20%) were non-responders. A history of smoking (p=0.006), was found to be a predictor of poor response to VDZ. 58% of subjects who had previously used greater than 2 anti-TNF therapies achieved remission versus 47% with 1 prior anti-TNF and 43% who were anti-TNF naive. Additionally, a low CRP value at time of initiation (p=0.001) was found to be a positive predictor of both response and remission. Responders to VDZ had a mean initiation CRP of 0.66 while non-responders had a mean initiation CRP of 2.99. Conclusion: In this cohort of subjects with longer duration of CD, VDZ was an effective treatment even with multiple prior anti-TNF exposures. A prior smoking history and a higher CRP at the time of treatment initiation may predict a poor response to VDZ treatment. These results may provide additional guidance in choosing optimal treatment for patients with CD.