Vedolizumab in Combination With Corticosteroids for Induction Therapy in Crohn's Disease: A Post Hoc Analysis of GEMINI 2 and 3

Bruce E Sands, Gert Van Assche, David Tudor, Gamar Akhundova-Unadkat, Rebecca I Curtis, Tjoeke Tan, Bruce E Sands, Gert Van Assche, David Tudor, Gamar Akhundova-Unadkat, Rebecca I Curtis, Tjoeke Tan

Abstract

Background: Combined therapy with vedolizumab and corticosteroids may improve clinical response or remission in Crohn's disease. The aim of this study is to assess efficacy and safety/tolerability of vedolizumab plus stable doses of corticosteroids at baseline during induction therapy in moderately to severely active Crohn's disease.

Methods: A post hoc exploratory analysis was performed on data from GEMINI 2 (NCT00783692) and GEMINI 3 (NCT01224171), which assessed outcomes following induction therapy over 6- and 10-week periods, respectively. Patients receiving vedolizumab or placebo were stratified by corticosteroid use at baseline. Efficacy endpoints were clinical remission (CR; Crohn's Disease Activity Index [CDAI] score ≤150 points) and enhanced clinical response (ECR; decrease of ≥100 points in CDAI score from baseline), assessed at week 6 (GEMINI 2 and GEMINI 3) and week 10 (GEMINI 3). Safety endpoints included the incidence of adverse events.

Results: Vedolizumab plus corticosteroids resulted in higher CR rates than placebo plus corticosteroids at week 6 in GEMINI 2 and at week 6 and week 10 in GEMINI 3. More patients receiving vedolizumab plus corticosteroids achieved CR at week 6 in GEMINI 2 and at week 10 in GEMINI 3 than patients receiving vedolizumab alone. Vedolizumab plus corticosteroids also resulted in significantly higher ECR rates than placebo plus corticosteroids at all timepoints in both studies. More patients receiving vedolizumab plus corticosteroids achieved higher ECR rates at week 6 in GEMINI 2 and at week 10 in GEMINI 3 than patients receiving vedolizumab alone. Adverse event incidence was similar across groups.

Conclusions: Vedolizumab in combination with stable doses of corticosteroids at baseline may improve induction of clinical response or remission in moderately to severely active Crohn's disease.

Trial registration numbers: NCT00783692, NCT01224171.

Keywords: Crohn’s disease; corticosteroids; induction; vedolizumab.

© 2019 Crohn’s & Colitis Foundation. Published by Oxford University Press on behalf of Crohn’s & Colitis Foundation.

Figures

FIGURE 1.
FIGURE 1.
Clinical remission and enhanced clinical response after induction treatment in GEMINI 2 and GEMINI 3 comparing (A) vedolizumab and placebo treatment arms (stratified by corticosteroid subgroup) and (B) corticosteroid and no-corticosteroid subgroups (stratified by treatment arm).

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