INTRODUCTION It is unclear whether vedolizumab therapy can be discontinued in patients with inflammatory bowel disease (IBD) after achieving steroid-free clinical remission. AIM To assess the risk of relapse after vedolizumab therapy was discontinued. PATIENTS AND METHODS Retrospective observational study, collecting data from 21 tertiary centres affiliated with the GETAID from January 2017 to April 2019. Consecutive patients with IBD who were in steroid-free clinical remission for at least three months and were treated with vedolizumab for at least six months were included at the time of vedolizumab discontinuation. RESULTS Ninety-five patients (58 with Crohn's disease) discontinued vedolizumab after a median duration of therapy of 17.5 [10.6-25.4] months. After a median follow-up period of 11.2 (5.8-17.7) months, 61 (64%) patients experienced disease relapse. The probabilities of relapse-free survival were 83%, 59% and 36% at 6, 12 and 18 months, respectively. According to the multivariate analysis, a CRP level less than 5 mg/L at vedolizumab discontinuation (HR=0.56, 95% CI [0.33-0.95], p=0.03) and discontinuation due to patients' elective choice (HR=0.41, 95% CI [0.21-0.80], p=0.009) were significantly associated with a lower risk of relapse. Re-treatment with vedolizumab was noted in 24 patients and provided steroid-free clinical remission in 71% and 62.5% at week 14 and after a median follow-up of 11.0 [5.4-13.3] months, respectively, without any infusion reactions. CONCLUSION In this retrospective study, two-thirds of patients with IBD treated with vedolizumab experienced relapse within the first year after vedolizumab discontinuation. Re-treatment with vedolizumab was effective in two-thirds of patients.

中文翻译：

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维多珠单抗停药后维持炎症性肠病患者缓解的一项多中心队列研究。

引言目前尚不清楚在无类固醇的临床缓解后，炎症性肠病（IBD）患者是否可以停止维多珠单抗治疗。目的评估维多珠单抗治疗中断后复发的风险。患者与方法回顾性观察研究，从2017年1月至2019年4月从21个隶属于GETAID的三级中心收集数据。连续的IBD患者接受无类固醇的临床缓解至少三个月，并接受维多珠单抗治疗至少六个月vedolizumab停药时已包括几个月。结果95名患者（58名克罗恩病患者）在中位治疗时间为17.5 [10.6-25.4]个月后停用了维多珠单抗。在平均随访时间为11.2（5.8-17.7）个月之后，61（64％）患者经历了疾病复发。在6、12和18个月时，无复发生存的概率分别为83％，59％和36％。根据多变量分析，在维多单抗停药（HR = 0.56，95％CI [0.33-0.95]，p = 0.03）和因患者的选择性选择而停药（HR = 0.41、95）时，CRP水平低于5 mg / L。 ％CI [0.21-0.80]，p = 0.009）与较低的复发风险显着相关。注意到24例患者接受vedolizumab的重新治疗，分别在第14周和中位随访11.0 [5.4-13.3]个月后无任何输注反应的情况下，无类固醇的临床缓解率分别为71％和62.5％。结论在这项回顾性研究中，接受维多珠单抗治疗的IBD患者中有三分之二在维多珠单抗停用后的第一年内复发。