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A clinical decision support tool may help to optimise vedolizumab therapy in Crohn's disease

Parambir S. Dulai Aurélien Amiot 1 Laurent Peyrin-Biroulet 2, 3 Vipul Jairaith 4 Mélanie Serrero 1 Jérome Filippi 5 Siddharth Singh 6 Benjamin Pariente 1 Edward V. Loftus 7 Xavier Roblin 8 Sunanda Kane Anthony Buisson 9 Corey A. Siegel 10 Yoram Bouhnik 11 William J. Sandborn 6, 7 Karen Lasch Maria Rosario 12 Brian G. Feagan 13 Daniela Bojic Caroline Trang-Poisson 14, 15, 16 Bo Shen 17 Romain Altwegg 1 Bruce E. Sands Jean-Frederic Colombel 18 Franck Carbonnel 19 Gursimran Kochhar Joseph Meserve Maria Barsky Brigid S. Boland Charlotte Gagniere 20 Marc-André Bigard 3 Camille Zallot 3, 2 Jean-Charles Grimaud 21 Xavier Hebuterne 5, 22 Maria Nachury 23 Pierre Desreumaux 23 Emilie del Tedesco 24 Gilles Bommelaer 9 Jenna L. Koliani-Pace Carmen Stefanescu 1 Arnaud Boureille 14 Robert Hirten Ryan Ungaro Thibaud Vaysse 25 Matthew Bohm Sashidhar Varma Monika Fischer 26 David Hudesman Shannon Chang Anne Bourrier 27 Philippe Seksik 28, 27 Laurent Beaugerie 29 Jacques Cosnes 27 Harry Sokol 28 Cécilia Landman 27 Dana Lukin Aaron Weiss Philippe Marteau 30 Xavier Dray 31, 32, 33 Stephane Nancey 1 Gilles Boschetti 34 David Laharie 35, 36 Florian Poullenot 36 Matthieu Allez 37 Jean-Marc Gornet 37 Clautilde Baudry 38 Guillaume Savoye 39, 40, 41, 42 Jacques Moreau 43 Lucine Vuitton 1 Stéphane Koch 44 Stéphanie Viennot 1 Alexandre Aubourg 45 Laurence Picon 46 Anne-Laure Pelletier 47 Gaelle Sickersen 48 Guillaume Bouguen 1 Vered Abitbol 49, 50 Stanislas Chaussade 49, 50 Stéphane Nahon 51 Mathurin Fumery 1, 52, 53 Betsy Winkfield 54, 1 Hedia Brixi-Benmansour 1 Rodica Gincul 55 Jean-Christophe Barberis 54 Bruno Bonaz 56 Christophe Michiels 57 Frank Zerbib 35 Marie Bourrier De Beauregard Christophe Locher 58 Sophie Davin-Couve 54 Armelle Poirette 54 Laurence Guillem 54 Monica Stetiu-Mocanu 54 Beau Philippe Sylvain Beorchia 54 Jawad Al Qaddi 54 Arun Swaminath Getaid Observ-Ibd Victory Cohorts Collaboration 
34 APY - Autophagie infection et immunité - Autophagy Infection Immunity
CIRI - Centre International de Recherche en Infectiologie - UMR
Abstract : Background A clinical decision support tool (CDST) has been validated for predicting treatment effectiveness of vedolizumab (VDZ) in Crohn's disease. Aim To assess the utility of this CDST for predicting exposure-efficacy and disease outcomes. Methods Using data from three independent datasets (GEMINI, GETAID and VICTORY), we assessed clinical remission rates and measured VDZ exposure, rapidity of onset of action, response to dose optimisation and progression to surgery by CDST-defined response groups (low, intermediate and high). Results A linear relationship existed between CDST-defined groups, measured VDZ exposure, rapidity of onset of action and efficacy in GEMINI through week 52 (P < 0.001 at all time points across three CDST-defined groups). In GETAID, CDST predicted differences in clinical remission at week 14 (AUC = 0.68) and rapidity of onset of action (P = 0.04) between probability groups. The high-probability patients did not benefit from shortening of infusion intervals, and differences in onset of action between the high-intermediate and low-probability groups within GETAID were no longer significant when including low-probability patients who received a week 10 infusion. CDST predicted a twofold increase in surgery risk over 12 months of VDZ therapy among low- to intermediate-probability vs high-probability patients (adjusted HR 2.06, 95% CI 1.33-3.21). Conclusions We further extended the clinical utility of a previously validated VDZ CDST, which accurately predicts at baseline exposure-efficacy relationships and rapidity of onset of action and could be used to help identify patients who would most benefit from interval shortening and those most likely to require surgery while on active therapy.
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https://hal-u-picardie.archives-ouvertes.fr/hal-03552288
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Soumis le : mercredi 2 février 2022 - 11:18:53
Dernière modification le : samedi 24 septembre 2022 - 15:10:05

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Parambir S. Dulai, Aurélien Amiot, Laurent Peyrin-Biroulet, Vipul Jairaith, Mélanie Serrero, et al.. A clinical decision support tool may help to optimise vedolizumab therapy in Crohn's disease. Alimentary Pharmacology and Therapeutics, Wiley, 2020, 51 (5), pp.553-564. ⟨10.1111/apt.15609⟩. ⟨hal-03552288⟩

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