P560 Incidence of joint symptoms in patients with inflammatory bowel disease on treatment with vedolizumab
M.A. RUIZ-RAMIREZ1, P. Rodríguez-Merlos2, C. Suarez1, C. Plasencia-Rodríguez2, V. Navarro-Compán2, J. Poza1, E. Martin-Arranz1, M. Sanchez-Azofra1, J.L. Rueda-Garcia1, L. Garcia-Ramirez3, K. Franco2, G. Bonilla2, D. Peiteado2, A. Balsa2, M.D. Martin-Arranz1
1Hospital Universitario La Paz, Gastroenterology, Madrid, Spain, 2Hospital Universitario La Paz, Rheumatology, Madrid, Spain, 3Hospital Universitario La Paz, Clinical Trials, Madrid, Spain
Background
Vedolizumab is a monoclonal antibody that binds to an integrin resulting in gut-selective anti-inflammatory activity. It is indicated for the treatment of inflammatory bowel disease (IBD), both in Crohn’s disease (CD) and ulcerative colitis (UC), but no benefit has been proved on inflammatory joint disease. The aim of this study was to analyse the incidence of the debut of inflammatory joint disease and also analyse the prevalence of outbreak of the previously known joint disease in IBD patients during treatment with vedolizumab.
Methods
Descriptive observational study of a prospective cohort of IBD patients treated with vedolizumab. All patients met the following inclusion criteria: adults > 18 years, histological diagnosis of CD or UC and having received or being currently being treated with vedolizumab. Demographic, clinical and analytical information were obtained from the Hospital’s database from both Gastroenterology and Rheumatology clinical records.
Results
A total of 44 patients (25 with CD and 19 with UC) were included. Of these, most had been pretreated with anti-TNF (41 switchers and 3 patients näive to biological therapy). The mean age of the included patients was 50 ± 15.4 years with predominantly female (54%). The mean follow-up time of patients in this study was 26 ± 10 months. In total, 13 patients (30%) presented joint symptoms during treatment with vedolizumab (8 with EC and 9 with UC). Of these 13 patients, 3 already had previous diagnosis of inflammatory joint pathology (spondyloarthritis), 6 patients debuted with inflammatory joint symptoms during treatment with vedolizumab and 4 mechanical arthralgias. Of the 6 patients with debut of inflammatory profile symptoms, inflammatory pathology was confirmed in 5 patients (spondyloarthritis) and 1 patient presented osteomuscular mechanical pathology. A total of 11 patients with the diagnosed rheumatological disease (25%) were observed in this cohort.
Conclusion
The incidence of inflammatory joint pathology in IBD patients treated with vedolizumab is similar to the one described in other cohorts regardless of the treatment received. Suspension of anti-TNF treatment to switch to vedolizumab may be associated with outbreaks of rheumatic disease. This presents a new challenge in the therapeutic approach, being crucial a multidisciplinary approach.