{
  "abstract": "Introduction Elective discontinuation of Vedolizumab (VDZ) may be considered in patients achieving deep remission, but real-world relapse and recapture outcomes remain insufficiently characterised. This study evaluates flare-free survival following VDZ withdrawal and the likelihood of regaining remission after flare.Methods A retrospective review was performed for patients who discontinued VDZ between 2017 and 2025 in a large tertiary IBD centre. Inclusion required cessation due to confirmed biochemical, radiological, endoscopic or histological remission. Time-to-flare was calculated from VDZ stop date to objective evidence of flare (calprotectin rise, imaging, or endoscopy). Patients not experiencing a flare were censored at last follow-up. Flare-free survival was plotted on a Kaplan–Meier curve. Recapture of remission rates and use of advance therapy were recorded.Results A total of 46 patients met inclusion criteria (mean age 43 years; 47.8% female; UC 31, CD 15). VDZ had been started as 1st-line therapy in 16, 2nd-line in 19, and 3rd-line in 11 patients. Median follow-up period was 76.9 months. 36 (78.3%) experienced an objective flare with median flare-free survival of 7.0 months (IQR: 6 – 10 months). Among those who had a flare, 33 (91.6%) recommenced advance therapy and 31 of which were restarted on VDZ. Of those recommencing VDZ, 21 (67.7%) recaptured remission. There was no statistically significant relationship between likelihood of flaring and whether VDZ had been started as first, second or third line of treatment (Chi Square, X =1.647, p=0.439).Conclusion Most patients relapsed following VDZ cessation typically within the first year. However, 2/3rd of patients successfully regained remission demonstrating good VDZ re-initiation response rates. Line of therapy of VDZ did not correlate with likelihood of flaring. Despite the significant cost savings of stopping VDZ, clinicians need to consider the risk to benefit ratio of stopping when relapse rate is high. Larger cohorts are needed to refine patient selection for safe treatment withdrawal",
  "authors": [
    {
      "affiliations": [
        "University College London Hospital, London, United Kingdom"
      ],
      "name": "Krithivasan P Raman"
    },
    {
      "affiliations": [
        "University College London Hospital, London, United Kingdom"
      ],
      "name": "Alasdair Sinclair"
    },
    {
      "affiliations": [
        "University College London Hospital, London, United Kingdom"
      ],
      "name": "Paul Harrow"
    },
    {
      "affiliations": [
        "University College London Hospital, London, United Kingdom"
      ],
      "name": "Misha Kabir"
    }
  ],
  "title": "P244 Clinical outcomes of vedolizumab withdrawal in inflammatory bowel disease patients",
  "uid": "c5b91462-f6b4-5791-8238-c1a2c2e8923f"
}