If subjects voluntarily consent to participation in the study, those who are finally determined to be eligible for the study after whether all of the inclusion criteria and none of the exclusion criteria are met is checked will receive the study drug. Efficacy and safety will be evaluated at baseline, baseline, 2 weeks, 6 weeks, 14 weeks, 22 weeks, 30 weeks, 38 weeks, 46 weeks, and 54 weeks.
This study, which is designed as a multicenter, open-label, single-arm, phase 3b clinical trial, is intended to evaluate the efficacy and safety of vedolizumab in biologic-naïve Korean patients with moderate-to-severe bowel disease. The study is conducted with a single arm, and the subjects to be recruited consist of 30 patients with Crohn's disease and 30 patients with ulcerative colitis (considering dropout rate of 20%). The total period after the subject enrollment is 54 weeks, and a total of 10 visits are made with screening, baseline, 2 weeks, 6 weeks, 14 weeks, 22 weeks, 30 weeks, 38 weeks, 46 weeks, and 54 weeks. * Crohn's disease (CD): If a subject does not respond to vedolizumab 300mg iv 0, 2, and 6 weeks for induction, an additional dose of vedolizumab 300 mg will be given at week 10. On the other hand, Maintenance therapy should be continued every 8 weeks from week 14 in responding patients, and for some patients who have experienced a decrease in their response, it can be given every 4 weeks.The maximum dosing period is 54 weeks. * Ulcerative colitis (UC): If a subject responds to vedolizumab 300mg iv 0, 2, and 6 weeks for induction, maintenance therapy should be continued every 8 weeks from week 14, and for some patients who have experienced a decrease in their response, it can be given every 4 weeks.The maximum dosing period is 54 weeks.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
60
* Crohn's disease (CD): If a subject does not respond to vedolizumab 300mg iv 0, 2, and 6 weeks for induction, an additional dose of vedolizumab 300 mg will be given at week 10. On the other hand, Maintenance therapy should be continued every 8 weeks from week 14 in responding patients, and for some patients who have experienced a decrease in their response, it can be given every 4 weeks. The maximum dosing period is 54 weeks. * Ulcerative colitis (UC): If a subject responds to vedolizumab 300mg iv 0, 2, and 6 weeks for induction, maintenance therapy should be continued every 8 weeks from week 14, and for some patients who have experienced a decrease in their response, it can be given every 4 weeks. The maximum dosing period is 54 weeks.
Yonsei University Health System, Severance Hospital
Seoul, South Korea
Clinical remission rate (%) at 14 weeks after commencement of vedolizumab treatment in induction phase
Clinical remission is defined as Mayo score ≤ 2 points and individual score ≤ 1 point for Ulcerative colitis and CDAI(Crohn's Disease Activity Index) \< 150 for Crohn's Disease.
Time frame: 14 weeks
Clinical remission rate (%) at 54 weeks in maintenance phase
Clinical remission is defined as Mayo score ≤ 2 points and individual score ≤ 1 point for Ulcerative colitis and CDAI(Crohn's Disease Activity Index) \< 150 for Crohn's Disease.
Time frame: 54 weeks
Response rate of dose intensification at 54 weeks in inadequate responders at 6 weeks
Response rate of dose intensification at 54 weeks in inadequate responders at 6 weeks
Time frame: 6 weeks, 54 weeks
Mucosal healing rate at 14 weeks and 54 weeks
Mucosal healing is defined as Mayo endoscopic subscore ≤ 1 for UC and as no visible ulcer for Crohn's Disease.
Time frame: 14 weeks, 54 weeks
Steroid free remission rate at 54 weeks
Steroid free remission rate at 54 weeks
Time frame: 54 weeks
Transmural healing rate at 14 weeks and 54 weeks for Crohn's Disease
Transmural healing is defined as normal cross-sectional imaging and mucosal healing.
Time frame: 14 weeks, 54 weeks
Correlation of CRP(C-reactive protein) level with clinical remission at 54 weeks.
The logistic regression will analyze CRP level to see the correlation with clinical remission.
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Time frame: 54 weeks
Correlation of fecal calprotectin level with clinical remission at 54 weeks
The logistic regression will analyze fecal calprotectin level to see the correlation with clinical remission.
Time frame: 54 weeks
Correlation of endoscopic severity with clinical remission at 54 weeks
The logistic regression will analyze endoscopic severity to see the correlation with clinical remission.
Time frame: 54 weeks
Correlation of radiologic severity with clinical remission at 54 weeks
The quality of life(QoL) will be assessed by IBDQ(Inflammatory Bowel The logistic regression will analyze radiologic severity to see the correlation with clinical remission.
Time frame: 54 weeks
Correlation of CDAI(Crohn's Disease Activity Index) score with clinical remission at 54 weeks
The logistic regression will analyze CDAI score to see the correlation with clinical remission.
Time frame: 54 weeks
Correlation of Mayo score with clinical remission at 54 weeks
The logistic regression will analyze Mayo score to see the correlation with clinical remission.
Time frame: 54 weeks
Changes in fecal microbiota after vedolizumab treatment: Microbiota change will be compared with baseline status using α diversity and β diversity.
Changes in fecal microbiota at 14 weeks and 54 weeks after treatment versus baseline are evaluated by α-diversity and β-diversity.
Time frame: Baseline, 14 weeks, 54 weeks
QoL(Quality of Life): IBDQ(Inflammatory Bowel Disease Questionnaire)
The quality of life(QoL) will be assessed by IBDQ(Inflammatory Bowel Disease Questionnaire) survey at week 0, week 14 and week 54. A paired data analysis will be conducted at week 14 and week 54 compared to week 0 (before treatment). It will be evaluated in Crohn's Disease and Ulcerative colitis, separately.
Time frame: Baseline, 14 weeks, 54 weeks