📈 New decision support for vedolizumab in UC: Real-world validation

🔥 Main in 3 points

• A clinical decision support tool (CDST) reliably stratifies UC patients by chance of vedolizumab response.
• In a Dutch real-world cohort, high-probability UC patients had markedly better clinical, biochemical, and steroid-free remission at week 54 (e.g., clinical remission: 81.8% vs 33.3%, p = 0.003).
• No predictive value of the CDST was found in Crohn's disease patients.

🧪 Context

Retrospective cohort (n = 41 UC, 32 CD) using validated CDST, compared vedolizumab responses in groups predicted to have high vs low/intermediate response probability.

📍 Practical significance

• For UC: Use CDST tools to guide patient selection for vedolizumab—high-score patients much more likely to achieve remission.
• For CD: Current scoring systems may not inform vedolizumab outcomes—clinical judgement prevails.
• Consider implementing validated prediction tools at point-of-care in UC for optimising therapy and resource allocation.

🔗 Source — PubMed | DOI

🔄 Vedolizumab is increasingly used post-liver transplant for UC—safety reassuring

🧾 For patients with UC after liver transplantation

• Most maintain clinical remission long-term post-LT (81.2%), similar to pre-LT levels.
• Moderate-to-severe endoscopic inflammation persists in ~28% despite stable symptoms.
• Use of advanced therapies—especially vedolizumab—increased significantly after LT (12.7% vs 3.7%, p = 0.005), with no uptick in infection risk.

⚠️ With caution

• Endoscopic surveillance remains crucial: symptoms may not reflect mucosal disease.
• Interdisciplinary collaboration is needed for therapy individualisation.

📍 What to do

• Don’t hesitate to use vedolizumab post-LT if needed; monitor for persistent endoscopic activity.
• Infection risk does not appear to rise with advanced therapy in this setting.

🔗 Source — PubMed | DOI

🛡️ Pharmacovigilance update: Gastrointestinal AEs with vedolizumab—FAERS decade review

🔥 Main in 3 points

• 10 years of FAERS data: 17,943 GI adverse event (AE) reports linked to vedolizumab, 95 event types exceeded signal threshold.
• 74% of signalled GI events are not detailed on current product labelling (notably, diarrhea, abdominal pain, haematochezia, frequent bowel movements).
• Serious GI AEs are more common in males and patients <50 kg; median onset: ~190 days.

🧪 Context

Retrospective review, 59,976 cases in the US FAERS 2014–2024, disproportionality analysis.

📍 Actions

• Stay vigilant for unlabelled GI AEs, especially early after initiation and in at-risk groups (men, lower body weight).
• Encourage AE reporting; integrate signal awareness into patient monitoring.

🔗 Source — PubMed | DOI