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Is there a role for vedolizumab in the treatment of ulcerative colitis and Crohn’s disease?

Authors Gilroy L, Allen P

Received 23 November 2013

Accepted for publication 3 February 2014

Published 22 May 2014 Volume 2014:7 Pages 163—172


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Leah Gilroy, Patrick B Allen

Department of Gastroenterology, Ulster Hospital, Dundonald, Belfast, Northern Ireland

Abstract: Inflammatory bowel disease (IBD) is an important cause of morbidity and mortality for millions of patients worldwide. Current treatment options include corticosteroids, 5-aminosalicylates, immunosuppressants, and TNFα antagonists. However, these are frequently ineffective in achieving sustained response and remission over time. At present, gastroenterologists lack safe and effective treatments if patients fail anti-TNF therapy. Vedolizumab is a promising new agent for IBD patients refractory to anti-TNF therapy. Vedolizumab is an integrin antagonist which is thought to act by reducing inflammation by selectively inhibiting leukocyte migration in the gut. Emerging evidence from clinical trials suggests a potential role for vedolizumab in both ulcerative colitis (UC) and Crohn’s disease (CD), particularly in patients who have previously failed biological therapy. The safety profile of vedolizumab appears reasonable, possibly because it has a “gut-selective” mode of action, with no reported cases of progressive multifocal leukoencephalopathy, a condition which has been linked to another integrin antagonist, natalizumab. This review discusses the available evidence for integrin antagonists and their potential role in the management of IBD.

Keywords: vedolizumab, ulcerative colitis, Crohn’s disease, inflammatory bowel disease

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