The safety of vedolizumab for ulcerative colitis and Crohn's disease

Jean Frédéric Colombel, Bruce E. Sands, Paul Rutgeerts, William Sandborn, Silvio Danese, Geert D'Haens, Remo Panaccione, Edward Vincent Loftus, Jr, Serap Sankoh, Irving Fox, Asit Parikh, Catherine Milch, Brihad Abhyankar, Brian G. Feagan

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289 Scopus citations

Abstract

Objective Vedolizumab is a gut-selective antibody to a4ß7 integrin for the treatment of ulcerative colitis (UC) and Crohn's disease (CD). We report an integrated summary of the safety of vedolizumab. Design Safety data (May 2009-June 2013) from six trials of vedolizumab were integrated. Adverse events were evaluated in patients who received =1 dose of vedolizumab or placebo and were reported as exposureadjusted incidence rates as the number of patients experiencing the event per 100 person-years (PYs) of exposure. Predictors of serious infection were assessed using a Cox proportional hazards model. Results In total, 2830 patients had 4811 PYs of vedolizumab exposure (median exposure range, 1- 1977 days). No increased risk of any infection or serious infection was associated with vedolizumab exposure. Serious clostridial infections, sepsis and tuberculosis were reported infrequently (=0.6% of patients). No cases of progressive multifocal leucoencephalopathy were observed. Independent risk factors for serious infection in UC were prior failure of a tumour necrosis factor a antagonist (HR, 1.99; 95% CIs 1.16 to 3.42; p=0.0122) and narcotic analgesic use (HR, 2.68; 95% CI 1.57 to 4.58; p=0.0003), and in CD were younger age (HR, 0.97; 95% CI 0.95 to 0.98; p<0.0001), corticosteroid (HR, 1.88; 95% CI 1.35 to 2.63; p=0.0002) or narcotic analgesic use (HR, 2.72; 95% CI 1.90 to 3.89; p<0.0001). Investigator-defined infusion-related reactions were reported for =5% of patients in each study. Eighteen vedolizumab-exposed patients (<1%) were diagnosed with a malignancy. Conclusions Vedolizumab has a favourable safety profile with low incidence rates of serious infections, infusion-related reactions and malignancies over an extended treatment period.

Original languageEnglish (US)
JournalGut
DOIs
StateAccepted/In press - Feb 18 2016

ASJC Scopus subject areas

  • Medicine(all)
  • Gastroenterology

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    Colombel, J. F., Sands, B. E., Rutgeerts, P., Sandborn, W., Danese, S., D'Haens, G., Panaccione, R., Loftus, Jr, E. V., Sankoh, S., Fox, I., Parikh, A., Milch, C., Abhyankar, B., & Feagan, B. G. (Accepted/In press). The safety of vedolizumab for ulcerative colitis and Crohn's disease. Gut. https://doi.org/10.1136/gutjnl-2015-311079