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Vedolizumab in the Treatment of Ulcerative Colitis: An Evidence-Based Review of Safety, Efficacy, and Place of Therapy

Authors Takatsu N, Hisabe T, Higashi D, Ueki T, Matsui T

Received 1 September 2019

Accepted for publication 8 March 2020

Published 1 April 2020 Volume 2020:15 Pages 7—20

DOI https://doi.org/10.2147/CE.S179053

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 4

Editor who approved publication: Professor Garry Walsh


Noritaka Takatsu,1 Takashi Hisabe,1 Daijiro Higashi,2 Toshiharu Ueki,1 Toshiyuki Matsui1

1Department Of Gastroenterology, Fukuoka University Chikushi Hospital, Fukuoka, Japan; 2Department Of Surgery, Fukuoka University Chikushi Hospital, Fukuoka, Japan

Correspondence: Toshiyuki Matsui Tel +81-92-921-1011
Fax +81-92-929-2630
Email matsui@fukuoka-u.ac.jp

Introduction: Selective blockade of the integrins and mucosal adhesion molecules is a promising therapeutic strategy for ulcerative colitis (UC). Vedolizumab (VDZ), a humanized IgG1 monoclonal antibody against α 4β 7 integrin, selectively blocks the trafficking of the leukocytes into the gastrointestinal tract through its binding with the α 4β 7 integrin.
Aim: In this review, we provide an overview of the unique mechanism of VDZ, along with its efficacy, safety, and pharmacokinetic and pharmacodynamic data obtained from clinical trials, observational studies, and meta-analyses.
Evidence Review: A positive exposure–efficacy relationship with regard to clinical remission and clinical response was apparent in VDZ induction therapy. No drug-specific safety signals are currently available.
Place in Therapy: VDZ has been shown to be effective as first- or second-line induction and maintenance therapy in UC.
Conclusion: VDZ is a safe and effective treatment option for patients with UC. Prolonged VDZ induction therapy may contribute to improved outcomes in patients with UC, particularly those previously treated with tumor necrosis factor-α. Prospective head-to-head study of VDZ and other biologics would alter the positioning of VDZ much more clearly.

Keywords: integrin antagonist, vedolizumab, ulcerative colitis, inflammatory bowel disease, safety, efficacy

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