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Vedolizumab Reduces Postoperative Crohn’s Disease Recurrence
Postoperative recurrence after ileocolonic resection is common in Crohn’s disease. This randomized trial suggests vedolizumab can reduce early endoscopic recurrence, offering an additional biologic option for preventing disease return after surgery.
Adults with Crohn’s disease who are post-ileocolonic resection, especially those with risk factors for recurrence; patients considering biologic prophylaxis after surgery; gastroenterologists and surgeons managing postoperative IBD care; clinicians interested in non–anti-TNF biologic options.
What To Know
Vedolizumab given within 4 weeks after ileocolonic resection lowered endoscopic recurrence at 26 weeks versus placebo in the multicenter REPREVIO trial (patients had ≥1 risk factor for recurrence). The primary outcome compared modified Rutgeerts scores; vedolizumab reduced rates of severe and any endoscopic recurrence.
Adverse events were similar between groups. Study limitations noted by the authors include small sample size and short follow-up. This randomized trial tested vedolizumab (300 mg IV at weeks 0, 8, 16, 24) versus placebo after ileocolonic surgery in Crohn’s patients with risk factors for recurrence.
At 26 weeks, vedolizumab-treated patients had lower endoscopic recurrence by modified Rutgeerts score and fewer cases of severe endoscopic recurrence. Serious adverse events occurred in a small proportion and were not linked to vedolizumab serum levels.
Decisions about postoperative prophylaxis should still be individualized with your gastroenterologist; this trial provides randomized evidence supporting vedolizumab as an option, especially for people with prior anti-TNF failure or contraindications to anti-TNF therapy.
Read the full Lancet Gastroenterology & Hepatology report (and disclosures) for detailed methods, endpoints, and longer-term follow-up plans if available.
The REPREVIO trial had a relatively small sample size and short follow-up (26 weeks for endoscopy). Results are from a published randomized trial reported in The Lancet Gastroenterology & Hepatology and summarized by Medscape; longer-term outcomes and broader confirmatory studies would strengthen confidence before changing standard practice.
Study drug and support were provided by Takeda; review disclosed author relationships.
