Vedolizumab and Infection Risk in UC Patients After Colectomy

Perioperative vedolizumab use is not associated with short-term postoperative infectious complications in patients with ulcerative colitis (UC) undergoing colectomy, according to a recent study.

However, previous evidence has suggested a potential association between perioperative vedolizumab use and a higher risk for short-term postoperative infectious complications.
________________________________________________________________________________________

RELATED CONTENT
Could Diet Be an Effective Treatment for Children with Crohn Disease or Ulcerative Colitis?
Ancillary Intervention Tied to Improved Quality of Life for Patients with Ulcerative Colitis
________________________________________________________________________________________

For their study, the researchers evaluated 170 patients with UC who had undergone a colectomy between 2006 and 2016, of whom 46% were women. Median patient age was 40 years. All patients in the study had been identified via chart review.

A total of 34 (20%) patients had received vedolizumab within 16 weeks of colectomy, 60 (35%) had received anti-tumor necrosis factor (anti-TNF) within 8 weeks, 32 (19%) had received a moderate to high dose of prednisone, and 71 (42%) had received other therapies at the time of colectomy.

The researchers identified short-term postoperative infectious and noninfectious complications within 30 days following colectomy, and calculated the comprehensive complication index based on all reported events.

A total of 47 (28%) patients had received pouch construction at first stage. However, this had been performed less frequently in patients on vedolizumab, anti-TNF, or steroids. Results indicated that 62 short-term infectious complications had occurred in 49 (29%) patients, and 75 noninfectious complications had occurred in 64 (38%) patients.

The researchers noted that only pouch construction had been independently associated with short-term postoperative infectious complications, overall complications, and more severe complications. They also found that perioperative medical therapy, including vedolizumab, had not impacted short-term outcomes in either the overall population or the subpopulation of patients with pouch construction at a second stage.

“Perioperative use of vedolizumab was not associated with short-term postoperative (infectious) complications,” the researchers concluded. “However, postponing pouch construction to a second stage of surgery is advisable in patients under biological therapy or moderate-to-high doses of steroids.”

—Christina Vogt

Reference:

Ferrante M, de Buck van Overstraeten A, Schils N, et al. Perioperative use of vedolizumab is not associated with postoperative infectious complications in patients with ulcerative colitis undergoing colectomy. J Crohn Colitis. 2017;11(11):1353-1361. https://doi.org/10.1093/ecco-jcc/jjx095.