Colon to Rectum

J Crohns Colitis. 2024;18(4):540–7

Vermeire S, Hanzel J, Löwenberg M, Ferrante M, Bossuyt P, Hoentjen F, Franchimont D, Palatka K, Peeters H, Mookhoek A, de Hertogh G, Molnár T, van Moerkercke W, Lobatón T, Clasquin E, Hulshoff MS, Baert F, D’Haens G; LOVE-UC study group

Early versus late use of vedolizumab in ulcerative colitis: Clinical, endoscopic, and histological outcomes


Background and aims: The authors explored the potential for differential efficacy of vedolizumab between early and late ulcerative colitis (UC) with evaluation of clinical, endoscopic, and histological endpoints.
Methods: This was a multicentre, multinational, open-label study in patients with moderately-to-severely active UC, defining early UC by a disease duration < 4 years and bio-naive and late UC by a disease duration > 4 years and additional exposure to tumour necrosis factor antagonists. Patients received standard treatment with intravenous vedolizumab for 52 weeks (300 mg weeks 0, 2, 6, every 8 weeks thereafter without escalation). The primary endpoint was corticosteroid-free clinical remission with endoscopic improvement (total Mayo score ≤ 2 with no subscore >1) at both weeks 26 and 52.
Results: A total of 121 patients were included: in the “early” group, 25 of 59 (42.4%) achieved the primary endpoint versus 19 of 62 (30.6%) in the “late” group (p = 0.18). There were no significant differences between the 2 groups in endoscopic improvement (week 26: “early” 32/59 [54.2%] vs. “late” 29/62 [46.8%]; p = 0.412; week 52: 27/59 [45.8%] vs. 25/62 [40.3%]; p = 0.546) or in histological remission (Robarts Histopathology Index < 3 without neutrophils in the epithelium and lamina propria) (week 26: 24/59 [40.7%] vs. 21/62 [33.9%]; p = 0.439; week 52: 22/59 [37.3%] vs. 22/62 [35.5%]; p = 0.837).

Conclusions: No significant differences in clinical, endoscopic, and histological outcomes were observed between “early” and “late” disease.

S. Vermeire, Department of Gastroenterology and Hepatology, Department of Chronic Diseases and Metabolism, University Hospitals Leuven, KU Leuven, Leuven, Belgium, E-Mail: severine.vermeire@uzleuven.be

DOI: 10.1093/ecco-jcc/jjad179

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