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The exposure-response relationship between vedolizumab (VDZ) trough levels (VTLs) and efficacy outcomes has been extensively studied, but data on early VTLs in Asian populations are limited. We assessed clinical outcomes and biochemical response using fecal calprotectin (BioRESFC) or C-reactive protein (BioRESCRP) at week 14 (W14) and W54, endoscopic healing (EH) at available follow-up time points, and the need for drug optimization during maintenance therapy among 67 patients treated with VDZ (39 Crohn’s disease CD, and 28 ulcerative colitis UC). Associations between early VTLs and outcomes were assessed, with VTL cut-offs proposed using the area under the receiver operating curve (AUC). CD patients achieving W14 BioRESCRP had higher VTLs at W6 and W14. W54 BioRESFC responders and those not requiring drug optimization had higher W14 VTLs (11.2 vs. 3.8 µg/mL, P = 0.036; 2.2 vs. 5.8 µg/mL, P = 0.004). Proposed W14 VTL cut-offs were 5.3 µg/mL (AUC 0.859) for BioRESFC and 4.6 µg/mL (AUC 0.765) for drug optimization. In UC patients, higher early VTLs were noted in those achieving W14 corticosteroid-free clinical remission, W14 BioRESFC, and W14 EH, but not consistently linked to W54 results. This real-life study suggests higher early VTLs correlated with better outcomes, with W14 VTLs potentially predicting long-term outcomes in CD patients. Future studies are needed to confirm these findings and guide VDZ therapy.
Kim et al. (Mon,) studied this question.