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Only for medical professionals to read and reference 61 patients with ulcerative colitis were treated with veldrizumab, 30 patients have completed 4 injections so far, 90% of the patients achieved clinical response after 14 weeks of treatment, and 50% of patients achieved Clinical remission
.
Ulcerative colitis (UC) is a chronic, progressive, and heterogeneous inflammatory bowel disease.
The disease frequently occurs in young adults.
The condition is complex and protracted, difficult to recover, recurring, and it is more likely to develop cancer.
It has been designated by the World Health Organization as one of the modern refractory diseases
.
In recent years, UC’s disease management strategy has evolved from symptom control to clinical/patient-reported remission (no blood in the stool, normal bowel frequency) and endoscopic remission (mucosal healing) to prevent disease progression and improve long-term prognosis [1,2 ] Therefore, more effective and safe new drugs are needed to help patients achieve their treatment goals
.
Verdrizumab is a new type of integrin antagonist, which is different from previous systemic biological agents.
As an intestinal selective biological agent, it has a new mechanism of action.
It will be officially launched in China in November 2020.
.
As of October 2021, Shaw Hospital Affiliated to Zhejiang University School of Medicine has used vedelizumab to treat a total of 61 patients with UC, including 54 first-line treatment and 7 second-line treatment
.
Now I will share the experience and summary of the use of Verdrizumab in our hospital with colleagues
.
01 Clinical features A total of 61 UC patients who used vedelizumab in our hospital.
The baseline clinical features of the patients are as follows: Table 1: Baseline status of UC patients 02 Treatment efficacy of 61 UC patients, 30 patients have completed 4 injections so far
.
Among them, 90% of patients achieved clinical response at 14 weeks, and 50% of patients achieved clinical remission
.
Figure 1: Clinical response rate and clinical remission rate of velizumab treatment.
In addition, laboratory examinations showed that the patient's C-reactive protein level was significantly reduced after 14 weeks of treatment, from 12.
64 before treatment to 3.
03, the difference was statistically significant Significance; the red blood cell sedimentation rate has also been observed to decrease in value (from 22.
58 to 17.
48)
.
Figure 2: C-reactive protein level and erythrocyte sedimentation rate before and after velizumab treatment 03 Clinical actual case sharing Now I am sharing a real case of receiving velizumab treatment in our center, take a look at velizumab How effective is the anti-antibody
?
Patient, male, 43 years old
.
Onset at the age of 34 (2011), repeated mucus and blood in the stool for more than 9 years
.
History of present illness and treatment: The patient had an increased number of stools more than 9 years ago, 2-3 times a day, with a small amount of mucus and blood
.
Colonoscopy showed left hemicolitis, Mayo score 2-3 points
.
Diagnosed as UC (primary E2 moderate to severe active period)
.
Symptoms improved after giving mesalamine orally + enema in sufficient quantities
.
More than 8 years ago, the patient relapsed due to mesalazine reduction.
Colonoscopy showed inflammation of the left colon
.
Hydrocortisone enema was added, and the symptoms improved, followed by mesalazine suppository treatment
.
After that, the patient's disease was relieved and alternated with activities.
Mesalazine was added orally during activities, and the patient's symptoms could be controlled
.
In August 2020, patients will have mucus and blood in the stool again, 5-6 times a day, and half of them have blood
.
Mesalazine 1g QID was added, and the improvement of blood and stool was not obvious
.
In November 2020, the patient was given a 300 mg intravenous infusion of vedelizumab
.
In April 2021, the patient's stool frequency dropped to 1-2 times/day, no blood in the stool, and colonoscopy showed that the mucosa was basically healed
.
Figure 3: Comparison of colonoscopy results before and after treatment.
Expert opinion.
According to the treatment experience of our center, veclizumab has a good effect on induction treatment of UC.
The induced clinical response rate of veclizumab reached 90% and clinical remission after 14 weeks.
The rate has reached 50%.
In recent years, the clinical application of vedelizumab in UC has increased.
With the transition from second-line applications to first-line applications, it is suggested that the earlier use of veldrizumab will benefit patients.
The benefits may be greater
.
This is consistent with the results of the GEMINI I study of vedelizumab.
The results of this study showed that patients with a shorter course of disease (1-3 years) received veldrizumab treatment compared to those with a disease course greater than 3 years.
The curative effect obtained is more significant (P<0.
001) [3]
.
In our center, a total of 61 UC patients were treated with vedelizumab, of which 54 were first-line treatment patients
.
Whether the first-line use of vedelizumab will affect the second-line anti-TNF treatment has always been a general concern of clinicians
.
The real-world EVOLVE study shows that the second-line anti-TNFα treatment after the failure of veldrizumab in the treatment of UC has similar efficacy compared with the first-line anti-TNFα treatment [4]
.
In terms of safety, veldrizumab is at the top of the "safety pyramid" of new biologics [5].
Studies have shown that veldrizumab has the same safety and low immunogenicity as placebo.
The increased risk of serious infections or opportunistic infections and malignant tumors may be irrelevant [6]
.
In our center, there are 9 patients who received vedelizumab with tumors, and no tumor recurrence has been observed after treatment
.
In general, veldrizumab is used as an intestinal selective biologic, and the consensus/opinions of relevant experts at home and abroad recommend it as the first-line drug for the treatment of UC [5]
.
It is hoped that with the widespread application in the future, veldrizumab can help more UC patients return to their normal lives
.
Expert introduction Comment expert Prof.
Qian Cao, Director of the Department of Gastroenterology, Chief Physician, and Doctoral Supervisor, Department of Gastroenterology, Run Run Run Shaw Hospital, Zhejiang University School of Medicine, Vice Chairman, Digestive Endoscopy Branch of Zhejiang Medical Association, Zhonghua Yan, Group Leader, Inflammatory Bowel Disease Group, Zhejiang Medical Association Executive Deputy Leader of the Youth Academic Group of the Journal of IBD Data compilation author Liu Rongbei, Doctor of Gastroenterology, Attending Physician, Core member of the IBD team of the Run Run Run Shaw Hospital, Zhejiang University School of Medicine, presided over national and provincial topics, and published several SCI papers on the IBD team of the Run Run Run Run School of Medicine, Zhejiang University.
The Inflammatory Bowel Disease Center of Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Park is one of China's "Excellent Diagnosis and Treatment Centers for Inflammatory Bowel Disease", integrating gastroenterology, general surgery, pathology, imaging, anorectal surgery, nutrition, obstetrics and gynecology, and nursing.
.
The center actively introduces international diagnosis and treatment concepts and technologies, cultivates domestic first-class experts in various fields, and treats a large number of difficult-to-referral patients at home and even abroad, and has a high influence in society and the industry
.
The Inflammatory Bowel Disease Center of Run Run Run Run Run Run has a wealth of clinical diagnosis and treatment experience: each year, about 4,000 difficult-to-referral inpatients from all over the country are admitted, including a large number of surgical patients
.
The center provides patients with the most cutting-edge diagnosis and treatment methods, and is always patient-centric.
The diagnosis and treatment plan for each difficult patient comes from the joint decision-making of the team
.
Adhering to the tenet of "cooperation, professionalism, rigor and excellence", we provide every patient with inflammatory bowel disease with the highest quality diagnosis and treatment services.
References: [1] Lin Xuanyong.
Electronic Journal of Clinical Medicine Literature.
2020; 7(12) :191-193.
[2] Li Yingchao, et al.
Journal of Xi'an Jiaotong University (Medical Edition).
2020;41(4):628-632.
[3]Feagan BG,et al.
N Engl J Med.
2013;369 (8):699-710.
[4]Sands BE,et al.
N Engl J Med.
2019;381(13):1215-1226.
[5]Wang Yingde.
Chinese General Practice.
2021;24(21): 2629-2633.
[6] Zhou Qingyang, et al.
Chinese Journal of Digestion, 2020,40(02):141-144.
Past review: Patients with recurrent ulcerative colitis, after first-line treatment with velizumab Achieve mucosal healing! For patients with ulcerative colitis who have recurrent infections, how should the treatment plan be decided? How to take medicine for elderly patients with ulcerative colitis? See the therapeutic benefit statement of intestinal selective biologics:
.
Ulcerative colitis (UC) is a chronic, progressive, and heterogeneous inflammatory bowel disease.
The disease frequently occurs in young adults.
The condition is complex and protracted, difficult to recover, recurring, and it is more likely to develop cancer.
It has been designated by the World Health Organization as one of the modern refractory diseases
.
In recent years, UC’s disease management strategy has evolved from symptom control to clinical/patient-reported remission (no blood in the stool, normal bowel frequency) and endoscopic remission (mucosal healing) to prevent disease progression and improve long-term prognosis [1,2 ] Therefore, more effective and safe new drugs are needed to help patients achieve their treatment goals
.
Verdrizumab is a new type of integrin antagonist, which is different from previous systemic biological agents.
As an intestinal selective biological agent, it has a new mechanism of action.
It will be officially launched in China in November 2020.
.
As of October 2021, Shaw Hospital Affiliated to Zhejiang University School of Medicine has used vedelizumab to treat a total of 61 patients with UC, including 54 first-line treatment and 7 second-line treatment
.
Now I will share the experience and summary of the use of Verdrizumab in our hospital with colleagues
.
01 Clinical features A total of 61 UC patients who used vedelizumab in our hospital.
The baseline clinical features of the patients are as follows: Table 1: Baseline status of UC patients 02 Treatment efficacy of 61 UC patients, 30 patients have completed 4 injections so far
.
Among them, 90% of patients achieved clinical response at 14 weeks, and 50% of patients achieved clinical remission
.
Figure 1: Clinical response rate and clinical remission rate of velizumab treatment.
In addition, laboratory examinations showed that the patient's C-reactive protein level was significantly reduced after 14 weeks of treatment, from 12.
64 before treatment to 3.
03, the difference was statistically significant Significance; the red blood cell sedimentation rate has also been observed to decrease in value (from 22.
58 to 17.
48)
.
Figure 2: C-reactive protein level and erythrocyte sedimentation rate before and after velizumab treatment 03 Clinical actual case sharing Now I am sharing a real case of receiving velizumab treatment in our center, take a look at velizumab How effective is the anti-antibody
?
Patient, male, 43 years old
.
Onset at the age of 34 (2011), repeated mucus and blood in the stool for more than 9 years
.
History of present illness and treatment: The patient had an increased number of stools more than 9 years ago, 2-3 times a day, with a small amount of mucus and blood
.
Colonoscopy showed left hemicolitis, Mayo score 2-3 points
.
Diagnosed as UC (primary E2 moderate to severe active period)
.
Symptoms improved after giving mesalamine orally + enema in sufficient quantities
.
More than 8 years ago, the patient relapsed due to mesalazine reduction.
Colonoscopy showed inflammation of the left colon
.
Hydrocortisone enema was added, and the symptoms improved, followed by mesalazine suppository treatment
.
After that, the patient's disease was relieved and alternated with activities.
Mesalazine was added orally during activities, and the patient's symptoms could be controlled
.
In August 2020, patients will have mucus and blood in the stool again, 5-6 times a day, and half of them have blood
.
Mesalazine 1g QID was added, and the improvement of blood and stool was not obvious
.
In November 2020, the patient was given a 300 mg intravenous infusion of vedelizumab
.
In April 2021, the patient's stool frequency dropped to 1-2 times/day, no blood in the stool, and colonoscopy showed that the mucosa was basically healed
.
Figure 3: Comparison of colonoscopy results before and after treatment.
Expert opinion.
According to the treatment experience of our center, veclizumab has a good effect on induction treatment of UC.
The induced clinical response rate of veclizumab reached 90% and clinical remission after 14 weeks.
The rate has reached 50%.
In recent years, the clinical application of vedelizumab in UC has increased.
With the transition from second-line applications to first-line applications, it is suggested that the earlier use of veldrizumab will benefit patients.
The benefits may be greater
.
This is consistent with the results of the GEMINI I study of vedelizumab.
The results of this study showed that patients with a shorter course of disease (1-3 years) received veldrizumab treatment compared to those with a disease course greater than 3 years.
The curative effect obtained is more significant (P<0.
001) [3]
.
In our center, a total of 61 UC patients were treated with vedelizumab, of which 54 were first-line treatment patients
.
Whether the first-line use of vedelizumab will affect the second-line anti-TNF treatment has always been a general concern of clinicians
.
The real-world EVOLVE study shows that the second-line anti-TNFα treatment after the failure of veldrizumab in the treatment of UC has similar efficacy compared with the first-line anti-TNFα treatment [4]
.
In terms of safety, veldrizumab is at the top of the "safety pyramid" of new biologics [5].
Studies have shown that veldrizumab has the same safety and low immunogenicity as placebo.
The increased risk of serious infections or opportunistic infections and malignant tumors may be irrelevant [6]
.
In our center, there are 9 patients who received vedelizumab with tumors, and no tumor recurrence has been observed after treatment
.
In general, veldrizumab is used as an intestinal selective biologic, and the consensus/opinions of relevant experts at home and abroad recommend it as the first-line drug for the treatment of UC [5]
.
It is hoped that with the widespread application in the future, veldrizumab can help more UC patients return to their normal lives
.
Expert introduction Comment expert Prof.
Qian Cao, Director of the Department of Gastroenterology, Chief Physician, and Doctoral Supervisor, Department of Gastroenterology, Run Run Run Shaw Hospital, Zhejiang University School of Medicine, Vice Chairman, Digestive Endoscopy Branch of Zhejiang Medical Association, Zhonghua Yan, Group Leader, Inflammatory Bowel Disease Group, Zhejiang Medical Association Executive Deputy Leader of the Youth Academic Group of the Journal of IBD Data compilation author Liu Rongbei, Doctor of Gastroenterology, Attending Physician, Core member of the IBD team of the Run Run Run Shaw Hospital, Zhejiang University School of Medicine, presided over national and provincial topics, and published several SCI papers on the IBD team of the Run Run Run Run School of Medicine, Zhejiang University.
The Inflammatory Bowel Disease Center of Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Run Park is one of China's "Excellent Diagnosis and Treatment Centers for Inflammatory Bowel Disease", integrating gastroenterology, general surgery, pathology, imaging, anorectal surgery, nutrition, obstetrics and gynecology, and nursing.
.
The center actively introduces international diagnosis and treatment concepts and technologies, cultivates domestic first-class experts in various fields, and treats a large number of difficult-to-referral patients at home and even abroad, and has a high influence in society and the industry
.
The Inflammatory Bowel Disease Center of Run Run Run Run Run Run has a wealth of clinical diagnosis and treatment experience: each year, about 4,000 difficult-to-referral inpatients from all over the country are admitted, including a large number of surgical patients
.
The center provides patients with the most cutting-edge diagnosis and treatment methods, and is always patient-centric.
The diagnosis and treatment plan for each difficult patient comes from the joint decision-making of the team
.
Adhering to the tenet of "cooperation, professionalism, rigor and excellence", we provide every patient with inflammatory bowel disease with the highest quality diagnosis and treatment services.
References: [1] Lin Xuanyong.
Electronic Journal of Clinical Medicine Literature.
2020; 7(12) :191-193.
[2] Li Yingchao, et al.
Journal of Xi'an Jiaotong University (Medical Edition).
2020;41(4):628-632.
[3]Feagan BG,et al.
N Engl J Med.
2013;369 (8):699-710.
[4]Sands BE,et al.
N Engl J Med.
2019;381(13):1215-1226.
[5]Wang Yingde.
Chinese General Practice.
2021;24(21): 2629-2633.
[6] Zhou Qingyang, et al.
Chinese Journal of Digestion, 2020,40(02):141-144.
Past review: Patients with recurrent ulcerative colitis, after first-line treatment with velizumab Achieve mucosal healing! For patients with ulcerative colitis who have recurrent infections, how should the treatment plan be decided? How to take medicine for elderly patients with ulcerative colitis? See the therapeutic benefit statement of intestinal selective biologics:
