ABSTRACT
Purpose
Vedolizumab (VDZ) was reported to be effective as a first-line biological in adult
ulcerative colitis (UC). The aim of this study was to investigate the safety and effectiveness
of VDZ as the first-line biological in pediatric refractory UC.
Methods
We retrospectively extracted data from pediatric patients with UC who received first-line
VDZ. The following were recorded: baseline characteristics; clinical activity of intestinal
disease, levels of fecal calprotectin (FC), C-reactive protein, and serum amyloid
A; and erythrocyte sedimentation rate. Clinical effectiveness, biochemical remission,
and safety of VDZ were also investigated.
Findings
Eight patients were identified (median age, 12 years). FC levels were abnormal in
all cases and were remarkably elevated in 3 patients. C-reactive protein, serum amyloid
A, and erythrocyte sedimentation rate values were abnormal in 2, 4, and 5 patients,
respectively. According to the pediatric UC activity index score, 1, 5, and 2 patients
had mild, moderate, and severe disease. Fourteen weeks after VDZ administration, 5
patients achieved remission, and 3 remained in remission until week 52. Of the 3 patients
who did not reach remission in week 14, two achieved remission by week 52. In week
52, five of the eight patients continued receiving VDZ and maintained remission. All
patients achieved clinical remission without corticosteroid use. No adverse events
were observed in any patient.
Implications
VDZ may serve as a safe and effective first-line biological option for treating pediatric
patients with UC. FC levels before VDZ administration may be predictive of long-term
remission.
Key words
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Article info
Publication history
Published online: June 29, 2022
Accepted:
June 7,
2022
Identification
Copyright
© 2022 Elsevier Inc.
