Retrospective Cohort Study of Infliximab and Vederizumab in the Treatment of Moderate-to-severe Ulcerative Colitis

Hanyu ZHANG; Juan LUO; Mingzhi DONG; Qiyin CHEN; Fengrui ZHANG; Rui GUO; Junying TONG; Yinglei MIAO

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Hanyu ZHANG, Juan LUO, Mingzhi DONG, Qiyin CHEN, Fengrui ZHANG, Rui GUO, Junying TONG, Yinglei MIAO. Retrospective Cohort Study of Infliximab and Vederizumab in the Treatment of Moderate-to-severe Ulcerative Colitis[J]. Journal of Kunming Medical University.

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Retrospective Cohort Study of Infliximab and Vederizumab in the Treatment of Moderate-to-severe Ulcerative Colitis

Hanyu ZHANG^{1, 2},
Juan LUO^{1, 2},
Mingzhi DONG³,
Qiyin CHEN^{1, 2},
Fengrui ZHANG^{1, 2},
Rui GUO^{1, 2},
Junying TONG⁴,
Yinglei MIAO^{1, 2
,
,}

1.
Dept.of Gastroenterology，The 1st Affiliated Hospital of Kunming Medical University，Kunming Yunnan 650032
2.
Yunnan Province Clinical Research Center for Digestive Diseases，Kunming Yunnan 650032
3.
Dept. of Gastroenterology，The 2nd People’s Hospital of Baoshan，Baoshan Yunnan，678000
4.
Dept. of Gastroenterology，The People’s Hospital of Wuhua District，KunmingYunnan 650032，China

Received Date: 2024-06-14
Available Online: 2024-11-21

Abstract

Abstract

Objective To compare the efficacy and safety of infliximab （IFX） and vedolizumab （VDZ） in the treatment of moderate-to-severe ulcerative colitis （UC）. Methods A total of 129 patients diagnosed with medium-to-severe ulcerative colitis and treated with IFX/VDZ in the First Affiliated Hospital of Kunming Medical University from January 2020 to December 2023 were retrospectively collected, with 65 in the IFX treatment group and 64 in the VDZ treatment group. Afer excluding 19 patients whose treatment course was less than 14 weeks due to serious data missing or non-therapeutic reasons, a total of 110 patients were included for analysis, including 55 in the IFX treatment group and 55 in the VDZ treatment group. Clinical symptoms, indicators related to the disease activity, endoscopic manifestations and adverse reactions occurred during the treatment were recorded before the treatment （0 week） and 14, 30, and 54 weeks of treatment, and whether there were differences in the efficacy and safety of the two drugs in the treatment of moderate to severe UC was analyzed. Results There were no significant differences in the baseline indexes between the two groups （P > 0.05）. The levels of inflammatory indicators （WBC, PLT, ESR, CRP） in IFX treatment group were higher than those in VDZ treatment group at week 14, and the level of nutrition indicator ALB was lower than those in VDZ treatment group at week 30, with statistical significance （P < 0.05）. There was no significant difference in other laboratory indexes among follow-up nodes （P > 0.05）. The clinical response rate of IFX treatment group and VDZ treatment group was not significantly different at week 14 （81.8% vs 85.5%）, week 30 （80.8% vs 92.5%） and week 54 （91.3% vs 90.0%）（P > 0.05）. There was no significant difference in clinical response rate at week 14 （41.8% vs 49.1%）, week 30 （50.0% vs 67.5%） and week 54 （65.2% vs 63.3%）（P > 0.05）. There was no significant difference in endoscopic response rate at week 14 （54.3% vs 72.2%）, week 30 （41.3% vs 73.3%） and week 54 （60.0% vs 75.0%）（P > 0.05）. There was no significant difference in the endoscopic response rate at week 14 （34.3% vs 55.6%） and week 54 （53.3% vs 54.2%）（P > 0.05）. The endoscopic response rate at week 30 （23.5% vs 73.3%） in IFX treatment group was lower than that in VDZ treatment group, the difference was statistically significant （P = 0.005）. There was no significant difference between IFX group and VDZ group （7.3% vs 1.8%） during 14 to 30 weeks of the treatment （P > 0.05）, and IFX group had the higher non-response rate during 30 to 54 weeks of treatment （16.4% vs 0） than VDZ group. The difference was statistically significant （P = 0.005）. There was no significant difference in the incidence of adverse reactions between IFX treatment group and VDZ treatment group （10.9% vs 5.5%）（P > 0.05）. Conclusion During the treatment of moderate to severe UC, no significant difference has been observed in the clinical response rate, clinical remission rate, endoscopic response rate and endoscopic remission rate between the IFX treatment group and the VDZ treatment group at week 14 and week 54, and the endoscopic remission rate in the IFX treatment group is lower than that in the VDZ treatment group at week 30. The non-response rate of IFX treatment group is higher than that of VDZ treatment group during the maintenance treatment, suggesting that IFX treatment group may have a higher long-term drug resistance rate. There is no significant difference in the incidence of adverse reactions between the two drugs.
- Ulcerative colitis,
- Retrospective cohort study,
- Biological agent,
- Infliximab,
- Vedelizumab

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