The Impact of Vedolizumab on COVID-19 Outcomes among Adult IBD Patients in the SECURE-IBD Registry

Manasi Agrawal, Xian Zhang, Erica J. Brenner, Ryan C. Ungaro, Michael D. Kappelman, Jean Frederic Colombel

Research output: Contribution to journalArticlepeer-review

19 Scopus citations

Abstract

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.

Original languageEnglish
Pages (from-to)1877-1884
Number of pages8
JournalJournal of Crohn's and Colitis
Volume15
Issue number11
DOIs
StatePublished - 1 Nov 2021

Keywords

  • Crohn's disease
  • Inflammatory bowel disease
  • coronavirus disease 2019
  • outcomes
  • ulcerative colitis
  • vedolizumab

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