Journal
JOURNAL OF CROHNS & COLITIS
Volume 15, Issue 11, Pages 1877-1884Publisher
OXFORD UNIV PRESS
DOI: 10.1093/ecco-jcc/jjab071
Keywords
Inflammatory bowel disease; Crohn's disease; ulcerative colitis; coronavirus disease 2019; vedolizumab; outcomes
Categories
Funding
- Helmsley Charitable Trust [2003-04445]
- National Center for Advancing Translational Sciences [UL1TR002489, T32DK007634, K23KD111995-01A1]
- Pfizer
- Takeda
- Janssen
- Abbvie
- Lilly
- Genentech
- Boehringer Ingelheim
- Bristol Myers Squibb
- Celtrion
- Arenapharm
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The study found that COVID-19 outcomes in IBD patients on VDZ were comparable to those on all other therapies. Compared to anti-TNF monotherapy, VDZ monotherapy was more likely to result in hospitalization, but less likely to result in severe COVID-19. Overall, VDZ appears to be safe in IBD patients with COVID-19.
Background: The impact of immune-modifying therapies on outcomes of coronavirus disease 2019 [COVID-19] is variable. The purpose of this study was to determine the impact of vedolizumab [VDZ], a gut-selective anti-integrin, on COVID-19 outcomes in inflammatory bowel disease [IBD] patients. Methods: Using data from the Surveillance of Coronavirus Under Research Exclusion for IBD [SECURE-IBD], an international registry of IBD patients with confirmed COVID-19, we studied the impact of VDZ on COVID-19 hospitalization and severe COVID-19 [intensive care unit stay, mechanical ventilation and/or death]. Results: Of 3647 adult patients on any IBD medication in the registry, 457 [12.5%] patients were on VDZ. On multivariable analyses using backward selection of covariates, VDZ use was not associated with hospitalization or severe COVID-19 when compared with patients on all other medications (adjusted odds ratio [aOR] 0.87; 95% confidence interval [CI] 0.71, 1.1 and aOR 0.95; 95% CI 0.53, 1.73, respectively). On comparing VDZ monotherapy to anti-tumour necrosis factor [anti-TNF] monotherapy, the odds for hospitalization, but not severe COVID-19, were higher [aOR CI 1.39; 95% CI 1.001, 1.90 and aOR 2.92; 95% CI 0.98, 8.71, respectively]. In an exploratory analysis, VDZ monotherapy, compared to anti-TNF monotherapy, was associated with new-onset gastrointestinal symptoms at the time of COVID-19, especially among patients whose IBD was in remission. Conclusions: COVID-19 outcomes among IBD patients on VDZ are comparable to those on all other therapies. Hospitalization, but not severe COVID-19, is more likely with VDZ monotherapy than with anti-TNF monotherapy. Overall, VDZ appears to be safe in IBD patients with COVID-19.
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