1. Presentation data from US VICTORY Consortium
US VICTORY Consortium: Real World Comparative Effectiveness of Vedolizumab and Anti-TNF: Crohn’s disease
Presentation data from US VICTORY Consortium
M. Bohm et al. ECCO 2018: OP025
ECCO 2018

2. Comparing Vedolizumab and Anti-TNF Effectiveness in Real World (Crohn’s disease)
AIM: Compare the effectiveness of VDZ to anti-TNF therapy for CD in clinical practice
COHORT: Multicenter, US-based consortium (VICTORY)
DESIGN: Propensity score matching (1:1)
Patient characteristics: Age, sex
Disease characteristics: Prior hospitalization, stricturing/penetrating disease complication history, prior bowel surgery, disease severity
Treatment history: steroid refractoriness/dependence, prior anti-TNF therapy failure
M. Bohm et al. ECCO 2018: OP025

3. Methods of Study for Crohn’s disease patients
OUTCOMES:
Clinical response and remission: Physician global assessment
Steroid-free response and remission: Achieving response/remission, tapering off steroids, and requiring no repeat steroid prescription for 4 weeks
Endoscopic healing: Absence of ulcers or erosions
ANALYSIS:
Cumulative rates of outcomes at 12 months
Cox proportional hazard models for comparative effectiveness
Adjusted for: concomitant steroid or IMM use, disease location (ileal vs. colonic), number of prior anti-TNF agents used
M. Bohm et al. ECCO 2018: OP025

4. Propensity Matching Results for Crohn’s Disease Vedolizumab vs Anti-TNF
1,122 CD patients identified, 538 included after matching
Propensity model AUC 0.80 for predicting VDZ vs. anti-TNF therapy
VDZ
Anti-TNF
VDZ
Anti-TNF
M. Bohm et al. ECCO 2018: OP025

5. Effectiveness Results for Crohn’s Disease Vedolizumab vs Anti-TNF
VDZ
Anti-TNF
aHR 95% CI
Clinical
remission
38%
34%
1.27
0.91 – 1.78
Steroid-free remission
26%
18%
1.75
0.90 – 3.43
Endoscopic
healing
50%
41%
1.67
1.13 – 2.47
Vedolizumab vs. Anti-TNF therapy in CD stratified by location
Location
Clinical Remission aHR, 95% CI
Steroid-Free Remission aHR, 95% CI
Endoscopic
Healing
aHR, 95% CI
Isolated small bowel disease
0.70
0.32 – 1.51
0.60
0.17 – 2.05
1.45
0.52 – 4.10
Colonic or
ileocolonic ds.
1.51
1.04 – 2.20
4.90
2.44 – 9.83
1.70
1.10 – 2.61
M. Bohm et al. ECCO 2018: OP025

6. Steroid-free remission
Comparative effectiveness of VDZ and TNF-antagonist therapy in CD: A multicentre consortium propensity score–matched analysis
Aim: To compare the effectiveness of VDZ to TNF-antagonist therapy for CD (data from the VICTORY consortium)
Results:
Propensity score matching accounted for age, sex, prior CD-related hospitalisation within the previous year, stricturing or penetrating disease complication history, prior bowel surgery, disease severity, steroid refractoriness or dependence, and prior TNF-antagonist failure
Cumulative rates of clinical, steroid-free, and endoscopic healing at month 12
VDZ (n=269)
TNF-antagonist (n=269)
HR 1.67, 95% CI
HR 1.27, 95% CI
HR 1.75, 95% CI
Clinical remission
Steroid-free remission
Endoscopic healing
CD, Crohn’s disease; CI, confidence interval; HR, hazard ratio; TNF, tumour necrosis factor; VDZ, vedolizumab.
Clinical remission=complete resolution of CD-related symptoms; steroid-free=on steroids at baseline, tapered off, no repeat steroid prescription for 4 weeks; endoscopic healing=absence of ulcers or erosions.
Bold red text indicates significance.
Bohm M, et al. ECCO 2018; Abstract OP025.

7. Conclusions
Cumulative rates for endoscopic healing were statistical significantly higher in VDZ treated CD patients as compared to anti-TNF treated
Cumulative rates for clinical remission and steroid-free remission were numerically higher in VDZ treated CD patients as compared to anti-TNF treated CD patients
CD patients with colonic or ileo-colonic involvement were statistical significantly more likely to achieve these outcomes with VDZ as compared to anti-TNF therapy
Randomized controlled trial data are needed to confirm these findings and determine the optimal position of VDZ in current algorithms
M. Bohm et al. ECCO 2018: OP025