{
  "abstract": "Vedolizumab and Ustekinumab were first approved by our trust for treatment of patients with Ulcerative Colitis (UC), Crohn’s Disease (CD) and IBD-U in 2018, before blueteq approval. Our aim was to assess the longer-term efficacy and safety of these drugs in children.This was an observational single centre cohort study. Data was collected from the electronic patient record platform Cerner millennium and analysed using excel.27 patients were studied in total. 23 patients were treated with Vedolizumab or Ustekinumab and 4 patients were treated with both. All patients had previously failed treatment with one or more anti TNFa medications and one had also failed treatment with a JAK2 inhibitor. All patients had an endoscopy prior to starting treatment.Clinical remission was defined as PUCAI/PCDAI <= 10. This was achieved in 78.6% of Vedolizumab patients at 12 weeks and 56.3% of Ustekinumab patients at 8 weeks. For those that remained on treatment with Vedolizumab 100% were in remission from week 52 to 208. For those who remained on treatment with Ustekinumab 87.5% were in remission at week 52 and 100% from week 104 to 208.Of the 14 patients that were treated with Vedolizumab, 4 (29%) experienced treatment failure. Of these two were due to primary non-response, one was due to secondary loss of response and one was due to poor control of psoriasis secondary to previous treatment with infliximab. These four patients were switched to Ustekinumab. The average amount of time these patients took Vedolizumab before treatment failure was 10.8 months.Of the 17 patients that were treated with Ustekinumab, 10 (58.8%) experienced treatment failure. 5 of these (50%) primary and 5 (50%) secondary loss of response. Of these 10 patients 7 were switched to Upacitinib and 3 to Risankizumab.Prior to treatment with Vedolizumab, patients had required on average 2.3 courses of steroids and during treatment no patients required steroids. No patients in the Vedolizumab treatment group had adrenal insufficiency.Prior to treatment with Ustekinumab patients had required on average 1.1 courses of steroids and during treatment 4 patients required treatment with a course of steroids. One patient in the Ustekinumab group had adrenal insufficiency.No patients taking Vedolizumab or Ustekinumab required surgery.In children with IBD that have lost response to anti TNF treatment, both Vedolizumab and Ustekinumab are effective and safe, with remission rates higher than published data.1 2 During treatment no patients required colectomy or long-term steroids.References Cohen S, Rolandsdotter H, Kolho KL, Turner D, Tzivinikos C, Bramuzzo M, et al. Effectiveness and safety of ustekinumab in pediatric ulcerative colitis: a multi-center retrospective study from the pediatric IBD porto group of ESPGHAN. Pediatric Drugs [Internet]. 2024 May 23;26(5):609–17. Available from: https://doi.org/10.1007/s40272-024-00631-zSingh N, Rabizadeh S, Jossen J, Pittman N, Check M, Hashemi G, et al. Multi-center experience of vedolizumab effectiveness in pediatric inflammatory bowel disease. Inflammatory Bowel Diseases [Internet]. 2016 Aug 19;22(9):2121–6. Available from: https://doi.org/10.1097/mib.0000000000000865Abstract OC105 Table 1VedolizumabUstekinumabn1417Median age at diagnosis(years)8.1 (1-14)9.8 (5-14)Diagnosis nUC: 10IBD-U: 2CD: 2UC: 2IBD-U: 1CD: 14Disease location(Paris classification) nL3: 1E2: 1E4: 12L1: 1L2: 2L3: 9E4: 2Disease duration prior to starting VDZ/UST (median)41 months (12-146)36 months (5-66)Duration of anti-TNF prior to starting VDZ/UST (median)15 months (5-54)23 months (3-65)Adverse events01 Psoriasis1 Acne",
  "authors": [
    {
      "affiliations": [
        "The Royal London Hospital"
      ],
      "name": "Alice Pearson"
    },
    {
      "affiliations": [
        "The Royal London Hospital"
      ],
      "name": "Roxana Mardare"
    },
    {
      "affiliations": [
        "The Royal London Hospital"
      ],
      "name": "Sophie Cox"
    },
    {
      "affiliations": [
        "The Royal London Hospital"
      ],
      "name": "Angela Cole"
    },
    {
      "affiliations": [
        "The Royal London Hospital"
      ],
      "name": "Sanhdia Naik"
    }
  ],
  "title": "OC105 Long-term follow up of real world data of children with inflammatory bowel disease (IBD) treated with Vedolizumab and Ustekinumab",
  "uid": "410898b6-65f6-5f60-b270-11915a6ea19d"
}