JDDH Journal

Abstract

Objectives: This study evaluated the effectiveness of switching from IV to SC vedolizumab in an IBD cohort and analysed costs from a hospital payor perspective. Methods: Patients receiving IV vedolizumab at a single IBD centre were assessed for eligibility to switch to SC formulation between February 2021 and March 2024. Baseline data and follow-up at 6 and 12 months were collected. The primary outcome was drug persistence at 12 months. Secondary outcomes included persistence at 6 months, clinical remission (HBI<4 for CD, SCCAI<3 for UC), and biochemical remission (CRP <5 mg/L and/or faecal calprotectin <250 µg/g) at 6 and 12 months. Cost savings were estimated using NHS vedolizumab prices. Data were analysed using t-tests, chi-square, and Kaplan-Meier analysis. Results: 265 patients on IV vedolizumab were identified; 50 were excluded due to dose escalation, disease phenotype, or compliance issues. Of 225 eligible patients, 114 continued IV therapy and 111 switched to SC. No significant demographic differences existed between cohorts. Median ages were 45.5 years (IV) and 53.5 years (SC); 58% male, 37% had CD.Twelve-month drug persistence was 90% (SC) and 93% (IV). At 6 months, persistence was 98% (SC) and 97% (IV). Clinical remission at 12 months was 89% (SC) vs 77% (IV) (p=0.016). Odds for remission with SC vedolizumab were 1.1 (p=0.7) at 6 months and 3.6 (p=0.006) at 12 months. Biochemical remission rates at 6 months were 81% (SC) and 71% (IV), and 77% for both at 12 months. In the SC group, 6% switched drugs due to loss of response, 1% due to surgery, and 3% reverted to IV due to adverse events or administration issues. Estimated annual cost savings were £683,944. Conclusion: Switching from IV to SC vedolizumab maintained persistence, improved clinical remission at 12 months, and reduced costs, supporting wider adoption of SC formulations.

Keywords: Drug; Inflammatory bowel disease Center; Vedolizumab; Gastrointestinal