Clinical Focus

  • Pediatric Gastroenterology

Academic Appointments

Professional Education

  • Fellowship: Stanford Health Care at Lucile Packard Children's Hospital (2024) CA
  • Board Certification: American Board of Pediatrics, Pediatric Gastroenterology (2023)
  • Fellowship: UCSF Pediatric Gastroenterology Fellowship (2023) CA
  • Board Certification: American Board of Pediatrics, Pediatrics (2021)
  • Residency: UCSF Pediatric Residency (2020) CA
  • Medical Education: University of California San Francisco Registrar Office (2017) CA

Contact

  • Academic
    patelpe@stanford.edu
    University - Academic staff Department: Pediatrics - Gastroenterology Position: Clinical Assistant Professor
  • Clinical (Primary)  Pediatric Gastroenterology 750 Welch Road Ste 116 Palo Alto, CA 94304 (650) 498-5608 (fax)

Additional Clinical Info

Additional Info

  • Mail Code: 5208

All Publications

  • Real-world effectiveness of ustekinumab and vedolizumab in TNF-exposed pediatric patients with ulcerative colitis. Journal of pediatric gastroenterology and nutrition Patel, P. V., Zhang, A., Bhasuran, B., Ravindranath, V. G., Heyman, M. B., Verstraete, S. G., Butte, A. J., Rosen, M. J., Rudrapatna, V. A., ImproveCareNow Pediatric IBD Learning Health System 2024

    Abstract

    OBJECTIVES: Vedolizumab (VDZ) and ustekinumab (UST) are second-line treatments in pediatric patients with ulcerative colitis (UC) refractory to antitumor necrosis factor (anti-TNF) therapy. Pediatric studies comparing the effectiveness of these medications are lacking. Using a registry from ImproveCareNow (ICN), a global research network in pediatric inflammatory bowel disease, we compared the effectiveness of UST and VDZ in anti-TNF refractory UC.METHODS: We performed a propensity-score weighted regression analysis to compare corticosteroid-free clinical remission (CFCR) at 6 months from starting second-line therapy. Sensitivity analyses tested the robustness of our findings to different ways of handling missing outcome data. Secondary analyses evaluated alternative proxies of response and infection risk.RESULTS: Our cohort included 262 patients on VDZ and 74 patients on UST. At baseline, the two groups differed on their mean pediatric UC activity index (PUCAI) (p=0.03) but were otherwise similar. At Month 6, 28.3% of patients on VDZ and 25.8% of those on UST achieved CFCR (p=0.76). Our primary model showed no difference in CFCR (odds ratio: 0.81; 95% confidence interval [CI]: 0.41-1.59) (p=0.54). The time to biologic discontinuation was similar in both groups (hazard ratio: 1.26; 95% CI: 0.76-2.08) (p=0.36), with the reference group being VDZ, and we found no differences in clinical response, growth parameters, hospitalizations, surgeries, infections, or malignancy risk. Sensitivity analyses supported these findings of similar effectiveness.CONCLUSIONS: UST and VDZ are similarly effective for inducing clinical remission in anti-TNF refractory UC in pediatric patients. Providers should consider safety, tolerability, cost, and comorbidities when deciding between these therapies.

    View details for DOI 10.1002/jpn3.12169

    View details for PubMedID 38482890