Long‐term safety of vedolizumab for inflammatory bowel disease

BACKGROUND: Vedolizumab, a gut‐selective α(4)β(7) integrin antibody, is approved for moderately to severely active ulcerative colitis (UC) and Crohn's disease (CD). AIM: To report the final results from the vedolizumab GEMINI long‐term safety (LTS) study. METHODS: The phase 3, open‐label GEMINI LTS study (initiated May 2009) enrolled patients with UC or CD from four prior clinical trials and vedolizumab‐naïve patients. Vedolizumab LTS was evaluated; efficacy and patient‐reported outcomes were exploratory endpoints. RESULTS: Enrolled patients (UC, n = 894; CD, n = 1349) received vedolizumab 300 mg IV every 4 weeks; median cumulative exposure was 42.4 months (range: 0.03‐112.2) for UC and 31.5 months (range: 0.03‐100.3) for CD. Over 8 years, adverse events (AEs) occurred in 93% (UC) and 96% (CD) of patients, with UC (36%) and CD (35%) exacerbations most frequent. Serious AEs were reported for 31% (UC) and 41% (CD) of patients. Vedolizumab discontinuation due to AEs occurred in 15% (UC) and 17% (CD) of patients. There were no new trends for infections, malignancies, infusion‐related reactions, or hepatic events, and no cases of progressive multifocal leukoencephalopathy. Of the ten deaths (UC, n = 4; CD, n = 6), two were considered drug‐related by local investigators (West Nile virus infection‐related encephalitis and hepatocellular carcinoma). Continuous vedolizumab maintained clinical response long‐term, with 33% (UC) and 28% (CD) of patients in clinical remission at 400 treatment weeks. CONCLUSIONS: The safety profile of vedolizumab remains favourable with no unexpected or new safety concerns. These results further establish the safety of vedolizumab and support its long‐term use (NCT00790933/EudraCT 2008‐002784‐14).