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Effects of vedolizumab versus adalimumab on QoL

Presented by
Dr E.V. Loftus, Mayo Clinic, USA
ECCO 2020
The effects of intravenous vedolizumab versus adalimumab on quality of life (QoL) were compared in a subanalysis of the VARSITY trial. More ulcerative colitis (UC) patients treated with vedolizumab than with adalimumab achieved clinically meaningful improvement and clinical remission, based on the Inflammatory Bowel Disease Questionnaire (IBDQ) scores [1].

VARSITY was the first head-to-head trial comparing the efficacy and safety of biologics in patients with moderately to severely active UC, and was one of the highlights of the 2019 edition of the ECCO-IBD meeting [2,3]. To assess QoL, the IBDQ was used. Clinically meaningful IBDQ improvement was defined as an increase in total score of ≥16 points from baseline to week 52; IBDQ remission was a total score of >170 points at week 52.

Results showed a clinically meaningful IBDQ improvement at week 52 in 199/383 patients (52.0%) versus 163/386 (42%) in the vedolizumab and adalimumab group, respectively (treatment difference 9.7%). IBDQ remission was achieved by 192 (50%) and 156 (40%) patients, respectively (treatment difference 9.6%). Mean changes in IBDQ total score from baseline for observed cases favoured vedolizumab over adalimumab (see Figure). IBDQ subscores showed similar favourable trends for vedolizumab. Reduced inflammation, as indicated by improvements in C-reactive protein (CRP) and faecal calprotectin (FCP), was consistent with improvements in QoL.

Figure. IBDQ total score changes from baseline at weeks 30 and 52 (full analysis set) [1]

Using efficacy data of the VARSITY trial, another study compared the cost-effectiveness of vedolizumab and adalimumab [4]. The clinical foundation of this model is predicated primarily on head-to-head evidence from phase 3 trials. Modelled outcomes indicated that UC patients are likely to achieve better clinical outcomes, as vedolizumab was associated with higher induction response (52.9% vs 45.1%) and remission rates (22.0% vs 14.4%). Also, based on US payer costings, lower direct medical costs are associated with vedolizumab (USD $90,673) than with adalimumab (USD $137,007), though this may not be applicable to other countries.

    1. Loftus EV, et al. ECCO-IBD 2020, DOP24.
    2. Schreiber S, et al. ECCO-IBD 2019, OP34.
    3. Sands BE, et al. N Engl J Med. 2019 Sep 26;381(13):1215-1226.
    4. Schultz R, et al. ECCO-IBD 2020, P607.



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