Vedolizumab for GI Acute GVHD Prevention and Treatment

By Patrick Daly - Last Updated: December 7, 2022

In a recent meta-analysis published in Frontiers in Immunology, researchers evaluated the safety and efficacy profile of vedolizumab for the prevention and treatment of gastrointestinal (GI) acute graft-versus-host disease (aGVHD). According to the study’s lead author, Allen Cheng-Wei Li, vedolizumab was effective and safe for early-grade GI aGVHD

The analysis included 122 patients from 8 studies published to the PubMed, Embase, Web of Science, and Cochrane Library databases by May 2022. One study examined vedolizumab as GVHD prophylaxis, and the remainder examined vedolizumab as GVHD treatment. Researchers used bivariate and random-effects models to assess primary end points, including overall response, complete response, mortality, and adverse events with vedolizumab.

Vedolizumab Effectively Treats GI aGVHD

Reportedly, the use of vedolizumab for the treatment of GI aGVHD yielded a significantly greater objective response rate (ORR) at day 14 (ORR, 60.53; risk ratio [RR], 14.14; 95% CI, 2.95-67.71), day 28 (ORR, 50%; RR, 7.36; 95% CI, 2.14-25.37), and month 12 (ORR, 76.92%; RR, 13.66; 95% CI, 3.5-53.35) from baseline.

In addition, vedolizumab led to significantly improved complete response (CR) rates at 12 months (CR, 27.27%; RR, 5.50; 95% CI, 1.01-29.95), although the authors noted that the CR at days 14 and 28 did not reach statistical significance. Vedolizumab as GVHD prophylaxis was not associated with any specific adverse events. Vedolizumab as GVHD treatment was associated with significantly increased risk of adverse events, including infections (RR, 7.55) and metabolic or nutritional consequences (RR, 9.0).

The authors suggested that vedolizumab was safe and effective in patients with GI aGVHD, especially earlier in the course of GVHD. “Further studies are warranted to elucidate its efficacy for the prophylaxis of GI aGVHD in patients undergoing [hematopoietic stem cell transplant],” they concluded.

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