1
|
Hajjat TM, Mosha M, Whaley KG, Rosen MJ, Suppa C, Markowitz J, Dufour L, Sauer C, Shukla-Udawatta M, Boyle B, Gibson M, Shapiro J, Sams D, Sylvester F, Hunter G, Perez ME, Hyams JS. Vedolizumab Experience in Children and Adolescents With Inflammatory Bowel Disease: A Multicenter Observational Study. Crohns Colitis 360 2021; 3:otab039. [PMID: 36776669 PMCID: PMC9802305 DOI: 10.1093/crocol/otab039] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Indexed: 11/13/2022] Open
Abstract
Background Vedolizumab is increasingly used off-label to treat children and adolescents with inflammatory bowel disease (IBD). In the absence of rigorous clinical trial experience, multicenter observational data are important to establish expectations for efficacy and safety. We examined 1-year outcomes following vedolizumab therapy in a large multicenter pediatric IBD cohort. Methods We performed a retrospective study of 159 pediatric patients (4-17 years old) with IBD [78, Crohn disease (CD); 81, ulcerative colitis/IBD-unspecified (UC/IBD-U)] treated with vedolizumab for 1 year at 8 pediatric medical centers in the United States. Demographics, clinical outcomes, laboratory data, and vedolizumab dosing were recorded. The primary outcome was corticosteroid (CS)-free clinical remission at 1 year. Other measured outcomes were clinical remission at 12 and/or 24 weeks, laboratory outcomes at 1 year, and endoscopy/histology results at 1 year. Results Among the 159 patients (mean age, 14.5 ± 2.4 years; 86% anti-TNF experienced), 68/159 (43%) achieved CS-free clinical remission at 1 year (CD, 35/78, 45%; UC/IBD-U, 33/81, 40%). Vedolizumab therapy failed and was discontinued in 33/159 (21%) patients prior to 1 year (CD, 18/78, 23%; UC/IBD-U, 15/81, 19%). While week 12 clinical remission was not predictive of 1-year clinical remission in either CD or UC/IBD-U, week 24 clinical remission was predictive of 1-year clinical remission only in CD patients. No infusion reactions or serious side effects were noted. Conclusions Vedolizumab was safe and effective in this pediatric population with approximately 43% achieving CS-free clinical remission at 1 year. Similar efficacy was noted in both CD and UC.
Collapse
Affiliation(s)
- Temara M Hajjat
- Division of Digestive Diseases, Hepatology, and Nutrition, Connecticut Children’s Medical Center, Hartford, Connecticut, USA,Address correspondence to: Temara M. Hajjat, MD, Pediatric Gastroenterology, Cincinnati Children’s Hospital and Medical Center, 3333 Burnet Avenue, MLC T8 (Office: 535), Cincinnati, OH 45229-3039, USA ()
| | - Maua Mosha
- Division of Digestive Diseases, Hepatology, and Nutrition, Connecticut Children’s Medical Center, Hartford, Connecticut, USA
| | - Kaitlin G Whaley
- Division of Pediatric Gastroenterology, Cincinnati Children’s Hospital Medical Center, and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Michael J Rosen
- Division of Pediatric Gastroenterology, Cincinnati Children’s Hospital Medical Center, and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Carmine Suppa
- Division of Pediatric Gastroenterology, Cohen Children’s Medical Center of NY, New Hyde Park, New York, USA
| | - James Markowitz
- Division of Pediatric Gastroenterology, Cohen Children’s Medical Center of NY, New Hyde Park, New York, USA
| | - Lauren Dufour
- Division of Pediatric Gastroenterology, Children’s Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Cary Sauer
- Division of Pediatric Gastroenterology, Children’s Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Monica Shukla-Udawatta
- Division of Pediatric Gastroenterology, Nationwide Children’s Hospital, Columbus, Ohio, USA
| | - Brendan Boyle
- Division of Pediatric Gastroenterology, Nationwide Children’s Hospital, Columbus, Ohio, USA
| | - Meghan Gibson
- Division of Pediatric Gastroenterology, Hasbro Children’s Hospital, Providence, Rhode Island, USA
| | - Jason Shapiro
- Division of Pediatric Gastroenterology, Hasbro Children’s Hospital, Providence, Rhode Island, USA
| | - Derica Sams
- Division of Pediatric Gastroenterology, University of North Carolina Health Care, Chapel Hill, North Carolina, USA
| | - Francisco Sylvester
- Division of Pediatric Gastroenterology, University of North Carolina Health Care, Chapel Hill, North Carolina, USA
| | - Gabriele Hunter
- Division of Pediatric Gastroenterology Goryeb Children’s Hospital AHS, Morristown, New Jersey, USA
| | - Maria E Perez
- Division of Pediatric Gastroenterology Goryeb Children’s Hospital AHS, Morristown, New Jersey, USA
| | - Jeffrey S Hyams
- Division of Digestive Diseases, Hepatology, and Nutrition, Connecticut Children’s Medical Center, Hartford, Connecticut, USA
| |
Collapse
|
6
|
McFall WT, Bader JD, Rozier RG, Ramsey D, Graves R, Sams D, Sloame B. Clinical periodontal status of regularly attending patients in general dental practices. J Periodontol 1989; 60:145-50. [PMID: 2746446 DOI: 10.1902/jop.1989.60.3.145] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Periodontal status of regular patients of general practitioners in the United States is unknown. A project assessing the effectiveness of continuing professional education in altering provider behavior and patient periodontal health provided the opportunity to clinically examine 1092 patients in the offices of 36 general practitioners. These regularly attending patients were selected by a random start systematic sample of patient records. The examination included recording missing teeth and assessing plaque, gingivitis, calculus, probing depth, and attachment loss on the facial and facial-mesial surfaces of the Ramfjord teeth (PDI). The mean patient age was 48 years, and 63% were female. The mean number of missing teeth, not including third molars, was 3.9. Almost 78% of the patients had no sites with a P1I score greater than 1, but 52% of the patients had at least one site with bleeding. Calculus was present in 62% of the patients. Deepest pocket depth was 4 mm or greater in 9% of patients and 3.8% had sites with 4 mm or greater attachment loss. Mean attachment loss was 1.6 mm across all sites. Although the majority of these regular patients had plaque, calculus, and gingivitis, only a minority exhibited periodontitis at the index sites.
Collapse
Affiliation(s)
- W T McFall
- School of Dentistry, University of North Carolina, Chapel Hill 27514
| | | | | | | | | | | | | |
Collapse
|