P450 Ustekinumab and vedolizumab for extraintestinal manifestations in inflammatory bowel disease
Livne- Margolin, M.(1);Ling, D.(1);Attia Konyo, S.(2);Haj, O.(1);Abitbol, C.M.(1);Ben-Horin, S.(1);Kopylov, U.(1);
(1)Tel-HaShomer Sheba Medical Center, Department of Gastroenterology, Ramat Gan, Israel;(2)Tel-HaShomer Sheba Medical Center, Internal Medicine E, Ramat Gan, Israel;
Background
: Extraintestinal manifestations (EIM) occur in up to 50 % of patients with inflammatory bowel disease (IBD) and are associated with significant morbidity and diminished quality of life. Ustekinumab (UST) and vedolizumab (VDZ) are effective for Crohn’s disease (CD) and ulcerative colitis (UC). However, their efficacy for treatment of EIM is not well established. The aim of our study was to compare the effectiveness of UST and VDZ for treatment of EIM in IBD.
Methods
We included IBD patients treated with VDZ or UST that are followed in the gastroenterology department of Sheba medical center between 2015 and 2021. Only patients with active EIM at the start of the treatment were included. The duration of follow- up was up to 52 weeks
Results
112 patients were included. Fifty-three patients (47%) were treated with ustekinumab and 59 (53%) with vedolizumab: 62(55%) women, 88% (n-99) had CD (52% had a small bowel,29% had both small bowel and colon disease location). Twenty-four patients (21%) were naïve to anti-tumor necrosis factor (TNF) inhibitors. The most common EIM was arthralgia (95/112, 84%). Patients treated with UST were more likely to be anti TNF experienced (n=51/53 [96%] compared with n=34/59 [58%], p<0.0001). Only 1 UC patient (1/53, 2%) treated with UST was included compared with 12 UC patients (12/59, 20%) in the VDZ group.
Clinical response of EIM at week 52 was achieved in 42% of patients treated with UST (n-20/47) and 25% of patients (n- 13/52) treated with vedolizumab, this difference was not statistically significant (p =0.08). There was no difference between UST and VDZ regarding their effect on EIM at earlier timepoints (week 6, 14, 26) (n-9/39 [23%] vs. n-17/56 [30%] p=0.8, n-9/36 [25%] vs. n-17/55 [31%], p=0.6, n-14/41 [34%] vs. n-17/55 [30%], p=0.8, respectively). The difference between groups was also not observed for specific types of EIMsConclusion
: In our retrospective study, no difference was found between VDZ and UST regarding their effect on EIM in IBD patients for up to 52 weeks of follow-up.