Vedolizumab in the Treatment of Ulcerative Colitis: An Evidence-Based Review of Safety, Efficacy, and Place of Therapy
Received 1 September 2019
Accepted for publication 8 March 2020
Published 1 April 2020 Volume 2020:15 Pages 7—20
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
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
This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.Download Article [PDF] View Full Text [HTML][Machine readable]