P138 - COMPARATIVE EFFECTIVENESS OF VEDOLIZUMAB VS. INFLIXIMAB INDUCTION THERAPY IN ULCERATIVE COLITIS: EXPERIENCE OF A REAL-WORLD COHORT AT A TERTIARY IBD CENTER
(Room Poster Hall)
19 Jan 18
5:30 PM
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7:00 PM
Tracks:
Defining Optimal Treatment Algorithms
Background: Vedolizumab (VDZ) and infliximab (IFX) are both approved as first line induction agents in moderately to severely active UC. However, there are no head-to-head studies comparing the relative effectiveness of the two. Here we provide a real-world comparison of these two agents. Methods: We conducted an ambidirectional cohort study of adult UC patients seen at our tertiary IBD center from 2012 to 2017. Each patient had moderately to severely active UC via clinical Mayo score, was induced with VDZ or IFX, and was followed until assessment of clinical response. Poisson Regression was used to calculate clinical response rates and rate ratios. Results: Of 59 patients who met inclusion criteria, 27 and 32 were induced with IFX and VDZ respectively. 18/27 (66.7%) patients induced with IFX vs. 24/32 (78.1%) patients induced with VDZ were clinical responders. Effect size calculation revealed no potential confounders. Response rates per 100 person-weeks (PW) were similar for VDZ (5.21) and IFX (5.38). The effectiveness in terms of induction of clinical response (incident rate ratio, IRR) was not significantly different for VDZ vs. IFX (IRR 0.97, 95% CI 0.53-1.77). Among TNF naïve patients, IRR was also not statistically significant between VDZ (6.74/100 PW) and IFX (6.48/100 PW) (IRR 1.04, 95% CI 0.47-2.29). Among TNF experienced patients there was a higher response rate for VDZ (4.52) vs. IFX (2.29) per 100 PW, but the IRR did not reveal statistical significance (IRR 1.97, 95% CI 0.45-8.63). Conclusion: Our study revealed a higher proportion of patients who responded to VDZ vs. IFX however clinical response rates were similar. A key difference between the two groups was the much higher response rate in the VDZ group among TNF-experienced patients - a larger cohort is needed to further elaborate on this difference. VDZ held its own against IFX and this study strengthens its standing as a potential first line agent among TNF naïve and experienced UC patients.