P0634Validation of the V-CDST score in Asian patients with Crohn’s disease using vedolizumab

Abstract Background The V-CDST score has been shown to predict the efficacy of vedolizumab (VDZ) in patients with Crohn’s disease (CD) who are newly started on VDZ in the western population, but validation data from Asia is sparse. Methods We evaluate the performance of V-CDST in predicting the efficacy of VDZ in Asian patients with CD. Data were retrieved from the local IBD Registry and electronic patient record to identify all CD patients newly started on VDZ from 2019 to 2024. The V-CDST consists of 5 clinical parameters at baseline including prior surgery, anti-TNF exposure, fistulizing disease, baseline albumin and C-reactive protein. Patients were then stratified into low, intermediate, and high probability of response. Primary outcome was persistence of VDZ at 12-month without switching to other biologics in three different strata. Secondary outcome was a composite CD-related complication endpoints at 12-month. Results A total of 103 CD patients (32.0% male, mean age 37.2 years and mean disease duration 6.3 years) were included. Among them, 31.1% had a history of bowel surgery, 20.4% had a history of fistulizing disease, 61.2% had received prior anti-TNF treatment and 11.7% had received prior Ustekinumab treatment. Based on the V-CDST, the number of patients in the high, intermediate, and low probability response groups was 31.1%, 43.7%, and 25.2%, respectively. At the end of 12-month, the persistence rate of VDZ treatment in patients with high probability of response was higher than that in patients with low probability of response (OR 3.96, p = 0.028, Table 1). They were also having a lower chance of switching biologics (OR 0.16, 95% CI, 0.05-0.48) and reaching the composite endpoint (OR 0.20, 95% CI 0.04-0.76) than those with low probability of response. Conclusion V-CDST is a good predictor of persistence of VDZ and low risk of CD-related complications at 12-month in Asian CD patients. Reference: Dulai PS, et al. A clinical decision support tool may help to optimise vedolizumab therapy in Crohn’s disease. Aliment Pharmacol Ther. 2020 Mar;51(5):553-564. Conflict of interest: Prof. Leung, Wai Keung: Speaker’s fee from AbbVie, Ferring, Johnson & Johnson. Consultant’s fee from Astra Zeneca, Johnson & Johnson, and Takeda. Ko, Kwan Lung: Speaker’s fee from AbbVie, Ferring, Johnson & Johnson. Consultant’s fee from Astra Zeneca, Johnson & Johnson, and Takeda. Cheung, Ka Shing: No conflict of interest