P461 Vedolizumab Dose Escalation in a Real-World Cohort of IBD Patients
Zelinkova, Z.(1);Kadleckova, B.(1);Lucenicova, J.(2);
(1)St. Michael`s Hospital, Department of Gastroenterology&Digestive Endoscopy, Bratislava, Slovakia;(2)St. Michael`s Hospital, Department Clinical Biochemistry&Hematology, Bratislava, Slovakia
In total, 75 IBD patients were included (mean age 47 years, range 20-90; 36 men; 35 CD/39UC/1 IBD-U). Fifty two pts (69%) were primary responders, out of these 23 pts (44%) required dose escalation at some point of the treatment due to secondary loss of response. Out of 23 primary non-responders, 10 stopped the treatment, the remaining 13 received escalated dose of VDZ.
Altogether, dose escalation was used in 36 pts (48%). There were no differences in the proportion of CD and UC between conventional and escalated dose regimen groups. Among secondary loss of response, the response was recaptured in 15 out of 23 pts (65%} while only two out of thirteen primary non-responders responded to dose escalation.
There were no significant differences in VDZ levels between pts requiring dose escalation and pts with stable response to conventional regimen (mean levels 9,97±1,276 vs. 12,79±1,771 µg/mL; p=n.s.). VDZ levels increased significantly in patients who responded to dose escalation (from 10,12±3,460 to 20,81±3,326 µg/mL; p=0.0497).
Response to vedolizumab can be successfully recaptured in two thirds of secondary non responders by dose escalation. Patients requiring dose escalation do not seem to differ from stable responders with regards to vedolizumab pharmacokinetics.