Vedolizumab versus Adalimumab for Moderate-to-Severe Ulcerative Colitis
Hi my name is elena welcome i’m going to talk about the evangelistic math versus adeline map for moderate to savor poserative colitis definition positive qualities is a chronic inflammatory disorder of the large vowel characterized by abdominal pain lotus diarrhea and fecal urgency adeline map a humanized monotronic antibody that binds and neutralizes cnf
Is widely used to treat positive qualities the good selective and integrated veterans map is an immunized monoclonal antibody that specifically binds to the leukocyte interline at the first beta7 what is ulcerative colitis ulcerative colitis is a chronic condition characterized by inflammation and sores or ulcers in the rectum and colon or large intestine
Ulcerative colitis can be distinguished based on how much of the large intestine is involved when ulcerative colitis involves only the rectum it is referred to as proctitis if the left side of the colon is involved it is known as left-sided colitis when the entire colon is involved it is known as pancolitis ulcerative colitis is characterized by periods of time
With active inflammation when the patient is experiencing symptoms and periods of time when the inflammation is turned off and the patient feels well we call these periods of wellness remission many patients with ulcerative colitis have long periods of remission alternating with periods of active inflammation which are called flares some patients with ulcerative
Colitis have more severe flares than others although the cause of ulcerative colitis is not known many factors can contribute to a person’s risk of having ulcerative colitis but most can be thought of in three categories genetic predisposition environmental factors and a dysregulated immune response in the gi tract which causes the inflammation environmental
Factors may include infections smoking and taking antibiotics or non-steroidal anti-inflammatory drugs or nsaids in ulcerative colitis inflammation appears within the colon and the immune system works to combat the bacteria and viruses as it does with a cut on the surface of the skin however the difference is that the immune system is not able to turn itself off
After it rids the body of the bacteria or viruses so the ulcers remain until they are treated with medicine or surgery this chronic inflammation is what causes the symptoms of ulcerative colitis in ulcerative colitis the rectum the last six inches of the large intestine is always involved the inflammation may involve additional areas of the large intestine above
This area in some patients the inflammation may extend further up into the colon and it is thought that in some patients the inflammation extends higher up over time approximately half of patients who do not have the whole colon involved at the time of diagnosis eventually progress to more extensive disease which may result in new symptoms or loss of response to
An existing therapy most of the symptoms of ulcerative colitis are related to the inflammation of the rectum when the rectum is inflamed it is not able to store contents or distinguish gas from liquid because of this patients frequently feel the urge to run to the bathroom or fear that they will leak or have an accident other symptoms of ulcerative colitis can
Include frequent small stools fatigue low energy and rarely fever because the rectum is always involved in ulcerative colitis patients usually experience similar symptoms regardless of how much of the colon is involved in addition to symptoms involving the colon ulcerative colitis can affect other parts of the body symptoms outside of the gi tract can include
Joint pain liver inflammation osteoporosis skin problems eye problems mouth ulcers and anemia patients with ulcerative colitis should expect to lead normal lives an important goal of the health care provider is to help people manage the disease rather than having the disease manage them application in medicine screening as assessments included a physical
Examination endoscopy findings were read at a central location the total mains conclude and still test tuberculosis screening the score on the inflammatory power this is questionary and questionary to identify possible symptoms of progressive multifocal liver hi my name is bruce sands i’m the chief of the division of gastroenterology at mount sinai medical center
In new york icon school of medicine at mount sinai and i’m talking about a publication about vitalism ab in patients with crohn’s disease published in gastroenterology federalism is an investigational agent that was recently approved for the treatment of crohn’s disease and ulcerative colitis and it’s a different biologic agent in that it targets alpha-4 beta-7
Integrin therefore it interferes with lymphocyte trafficking to the gut in the gemini 2 study this agent proved to be effective for induction and maintenance therapy in patients with active crohn’s disease who had failed other therapies this study looked at patients who had prior treatment for their crohn’s disease who had moderately to severely active crohn’s
These were adult patients between 18 and 80 years of age they had crohn’s disease diagnosed at least three months and they all had moderately to severely active crohn’s disease as defined by a cdai between 220 and 400 at screening and they also showed biologic indicators of inflammation including an elevated c-reactive protein or colonoscopic findings of active
Crohn’s disease or a elevated fecal cow protectant of more than 250 micrograms per gram of stool all of them had active disease in the ilium and or the colon and all of them had inadequate response or intolerance within five years to enantionf and or immune modulators and or corticosteroids the emphasis of the study was on patients who had prior treatment with
Anti-tnfs which comprised 75 percent of the treated population the study design was very simple it included a one-to-one randomization stratified for prior anti-tnf failure and patients were assigned to 10 weeks of active treatment and were given either placebo infusion at weeks zero two and six or were given three hundred milligrams infusion of vetalism at weeks
Zero two and six the primary endpoint was at week 6 and a secondary analysis was done at week 10. the primary efficacy endpoint was clinical remission as defined by a cdai of less than or equal to 150 at week 6 in patients who had had prior anti-tnf failure however predefined secondary endpoints included clinical remission at week 6 in the overall population
Including both anti-tnf naive and tnf failure patients and clinical remission at week 10 in the anti-tnf failure and overall populations 416 patients were enrolled including 315 patients who had prior tnf antagonist failure and 101 patients who were tnf antagonists naive more than half of the patients had corticosteroid use at the time that they were enrolled in
The study about one-quarter to one-third of patients were on concomitant immune modulators and in the tnf failure population all the patients had prior anti-tnf experience and in the overall population 75 percent had prior ntt f experience the median cdi for this population was moderately severe at roughly 314 pros and cons the drug by the losing map modifies
The entry of inflammatory cells into the intestine and other lingual mass it can be used shortly after diagnosis if you have a disease or if you have a large saver crohn’s disease and in turn can reduce signs and symptoms it can also be used after other medications have pilots to control symptoms cons metabolism does not bind to the alpha 4 and beta 1 and
Alpha e and beta 7 integrands are in with their function likewise it did not induce alteration in system immunoseparation a fact that does not effect affect the immune silver supervised mechanisms of the central nervous system however adeline map carries a small risk of complications including tuberculosis and serious fungal infection it’s so applied in a word
Globally there has been encrypted in case of inflammatory disease in its two varieties but in conservative qualities and crohn’s disease the hospital where the most case of the ulcerative colitis were treated was the romanov carbo from guayaquil and for carlos andrade marine from keto recording biological therapy by crown disease versus ulcerative colitis 45
Percent and 31 percent responsibility therefore we determine night that in acquire the use of biological therapy differs between the standards in which the study was conducted conclusion the current use of medicine map tends to be in other fashions with active alternative qualities moderate to saver who have had in inadequate response have loss of responses or
Are interested to conventional treatment for ntt and f with low response possibilities even so in several studies it has been shown to be effective with a low grade or seed side effects probably in the filter it will be used at least to increase the season rate
Transcribed from video
Vedolizumab versus Adalimumab for Moderate-to-Severe Ulcerative Colitis By Viviana Guarco
