Medscape review of new crohn's drug

[my little penguin]

http://www.medscape.com/viewarticle/821449?src=wnl_edit_tpal&uac=185734DZ

 

[superzeeman]

Says it requires a password to see it?

 

[my little penguin]

It free just sign up

 

[greypup]

MLP,

I read it but would you mind summarizing ;-) ?

 

[Essieluv]

I think vedolizumab looks very promising. However, I'm not crazy about the potential side effects. Then again, are there any drugs for IBD with nice side effects....?

 

[kiny]

They tested it in the hospital I go to, it is effective for UC, it is extremely ineffective for crohn's disease.

The results echo all the letters doctors wrote that the drug is not effective nor does it have a good safety record to warrant it being used for CD:

http://onlinelibrary.wiley.com/doi/10.1002/ibd.21078/full

"Veto on vedolizumab (MLN0002) for Crohn's disease

The compound failed to meet its primary endpoint in the current study. While one could argue about the validity of the primary CDAI cutoff, the fact that another instrument, the IBDQ, could not detect any clinical benefit for the patients is concerning.

This trial also does not add convincing new safety data for the anti-integrin concept due its small patient number compared with the natalizumab program and considering how many exposed patients it took to uncover the JC virus problem. JC viremia screening, as performed in this trial, does not help with risk reduction either, since it is not an appropriate screening method.11 Unfortunately, the statement that further PML cases would not have been reported after the adoption of the risk-minimization program by the FDA no longer holds true, since 3 days after publication of this study a new (fourth) natalizumab-related PML case was reported.

Nil nocere, “first do no harm,” should not be abandoned even though some of our patients desperately need new treatments and anti-integrin strategies are promising. The clinical investigators among us need to strive to develop better efficacy measurement tools, while we need basic scientists to provide us with practicable and reliable assays to screen and monitor our patients for JC virus infections. Until we have accomplished these goals, I propose a veto on vedolizumab in CD."

Baumgart is a Professor at the University hospital in Berlin.


I can tell you that doctors here are completely opposed to trying this for CD patients, the risk far outweight the benefits. I can also tell you that many hospitals refuse to try this drug for CD patients.

People say pentasa is not effective...pentasa in trials has been more effective than vedoluzimab, that's the kind of awful remission rates the actual studies have had with it for CD patients.

The studies that were actually published were the good studies, and even they were awful, because many ppl got vedoluzimab (they often call it millenium) in hospitals and many have refused to participate after none of their patients improved.

I'm not in a posiition to tell people which drugs to consider, but I would really think twice before trying that drug, especially for people where infliximab or other drugs work, it is a very high risk drug with awful remission scores.

Look up the studies, read the studies, read more than the CDAI scores, try to find rutgeerts scores, and it will become very apparent that this drug is not very helpful to treat crohn's disease, it takes far more than CDAI or PCDAI before you can determine if a drug is effective, and it has failed to meet all criteria except for CDAI, and even the CDAI remission scores were abysmal.

 

[Essieluv]

I agree with you Kiny, vedolizumab looks much more promising for UC. The studies that have been published so far are very blurry and nonspecific. Still, progress is progress.