University of Oulu

Sara Kolehmainen, Tero Ylisaukko-oja, Jari Jokelainen, Mirkka Koivusalo, T. Sakari Jokiranta & Taina Sipponen (2021) Benefit of measuring vedolizumab concentrations in inflammatory bowel disease patients in a real-world setting, Scandinavian Journal of Gastroenterology, 56:8, 906-913, https://doi.org/10.1080/00365521.2021.1938206

Benefit of measuring vedolizumab concentrations in inflammatory bowel disease patients in a real-world setting

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Author: Sara Kolehmainen, Sara1; Ylisaukko-oja, Tero2,3; Jokelainen, Jari2,3;
Organizations: 1Faculty of Medicine, University of Helsinki, Helsinki, Finland
2MedEngine Oy, Helsinki, Finland
3Faculty of Medicine, Center for Life Course Health Research, University of Oulu, Oulu, Finland
4Tammer BioLab Ltd, Tampere, Finland
5Department of Gastroenterology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 1.2 MB)
Persistent link: http://urn.fi/urn:nbn:fi-fe2021090144907
Language: English
Published: Informa, 2021
Publish Date: 2021-09-01
Description:

Abstract

Objectives: We set out to determine the reasons for serum vedolizumab (VDZ) trough concentration (TC) measurements in inflammatory bowel disease (IBD) patients and to evaluate treatment modifications after therapeutic drug measurement (TDM). We also evaluated the effect of increased dosing on patients’ response to VDZ therapy.

Methods: We performed a retrospective cohort study of IBD patients who received VDZ therapy at Helsinki University Hospital and whose VDZ levels were measured between June 2014 and December 2018.

Results: Altogether, 90 patients (32 Crohn's disease and 58 ulcerative colitis) and 141 VDZ TC measurements were included. 24.1% of measurements took place during induction and 75.9% during the maintenance phase. During induction, 64.7% reached the target TC >20µg/ml. During maintenance therapy, 82.2% of VDZ TCs were within or exceeded the suggested target range of 5–15µg/ml. Reasons for TDM were: secondary nonresponse (44.0%), assessment of adequate VDZ TC (25.5%), primary nonresponse (12.8%), adverse events (6.4%), and other (11.3%). No treatment changes occurred after 60.3% of VDZ measurements. Increased dose frequency was used after 25.5% of VDZ measurements and 33.3% of these patients experienced improvement. Altogether, 31 (34.4%) patients discontinued the therapy due to inadequate treatment response. No anti-vedolizumab antibodies were detected.

Conclusions: During the maintenance of VDZ therapy, the majority of VDZ TCs were within the suggested range. Measurement of VDZ TC did not lead to any treatment changes in two-thirds of patients. Dose optimization occurred in a quarter of patients and a third of them benefited from it.

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Series: Scandinavian journal of gastroenterology
ISSN: 0036-5521
ISSN-E: 1502-7708
ISSN-L: 0036-5521
Volume: 56
Issue: 8
Pages: 906 - 913
DOI: 10.1080/00365521.2021.1938206
OADOI: https://oadoi.org/10.1080/00365521.2021.1938206
Type of Publication: A1 Journal article – refereed
Field of Science: 3121 General medicine, internal medicine and other clinical medicine
Subjects:
Copyright information: © 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License (http://creativecommons.org/licenses/by-nc-nd/4.0/),which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited, and is not altered, transformed, or built upon in any way.
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