BACKGROUND: Vedolizumab is a humanized immunoglobulin G1 monoclonal antibody, which binds to α4β7 integrin on T lymphocytes, thus disturbing the interaction with mucosal vascular addressin cell adhesion molecule 1 on the intestinal endothelial cells to interfere with lymphocyte trafficking to the gut. SUMMARY: Vedolizumab is a safe and effective drug to induce and maintain clinical remission in patients with Crohn's disease (CD) and ulcerative colitis (UC) in both clinical trials and real-world data. Various guidelines recommend vedolizumab as a first- or second-line treatment regimen for steroid-dependent, steroid, or immunomodulator refractory cases of UC and CD; however, it is more effective in anti-TNF-naive patients. The first head-to-head trial (VARSITY trial) comparing the efficacy of vedolizumab to adalimumab has shown better clinical remission and mucosal healing with vedolizumab. KEY MESSAGES: In this review, we have discussed guidelines recommendation of vedolizumab use, as well as its safety data, use in special population, in presence of extraintestinal complications, therapeutic drug monitoring, data from Asian patients, along with other evolving concepts. Because of its excellent safety data and low immunogenicity, vedolizumab is an impressive option for patients with prior malignancy and less chance of reactivation of tuberculosis; however, cost remains an issue.
BACKGROUND: Vedolizumab is a humanized immunoglobulin G1 monoclonal antibody, which binds to α4β7 integrin on T lymphocytes, thus disturbing the interaction with mucosal vascular addressin cell adhesion molecule 1 on the intestinal endothelial cells to interfere with lymphocyte trafficking to the gut. SUMMARY: Vedolizumab is a safe and effective drug to induce and maintain clinical remission in patients with Crohn's disease (CD) and ulcerative colitis (UC) in both clinical trials and real-world data. Various guidelines recommend vedolizumab as a first- or second-line treatment regimen for steroid-dependent, steroid, or immunomodulator refractory cases of UC and CD; however, it is more effective in anti-TNF-naive patients. The first head-to-head trial (VARSITY trial) comparing the efficacy of vedolizumab to adalimumab has shown better clinical remission and mucosal healing with vedolizumab. KEY MESSAGES: In this review, we have discussed guidelines recommendation of vedolizumab use, as well as its safety data, use in special population, in presence of extraintestinal complications, therapeutic drug monitoring, data from Asian patients, along with other evolving concepts. Because of its excellent safety data and low immunogenicity, vedolizumab is an impressive option for patients with prior malignancy and less chance of reactivation of tuberculosis; however, cost remains an issue.
Authors: Mahmoud H Mosli; John K MacDonald; Stephen J Bickston; Brian W Behm; David J Tsoulis; Jianfeng Cheng; Reena Khanna; Brian G Feagan Journal: Inflamm Bowel Dis Date: 2015-05 Impact factor: 5.325
Authors: Davide Giuseppe Ribaldone; Rinaldo Pellicano; Marta Vernero; Gian Paolo Caviglia; Giorgio Maria Saracco; Mario Morino; Marco Astegiano Journal: Scand J Gastroenterol Date: 2019-04-04 Impact factor: 2.423
Authors: Neeraj Narula; Farhad Peerani; Joseph Meserve; Gursimran Kochhar; Khadija Chaudrey; Justin Hartke; Prianka Chilukuri; Jenna Koliani-Pace; Adam Winters; Leah Katta; Eugenia Shmidt; Robert Hirten; David Faleck; Malav P Parikh; Diana Whitehead; Brigid S Boland; Siddharth Singh; Sashidhar Varma Sagi; Monika Fischer; Shannon Chang; Morris Barocas; Michelle Luo; Karen Lasch; Matthew Bohm; Dana Lukin; Keith Sultan; Arun Swaminath; David Hudesman; Nitin Gupta; Bo Shen; Sunanda Kane; Edward V Loftus; Corey A Siegel; Bruce E Sands; Jean-Frederic Colombel; William J Sandborn; Parambir S Dulai Journal: Am J Gastroenterol Date: 2018-06-27 Impact factor: 10.864
Authors: Martin Gregory; Kimberly N Weaver; Patrick Hoversten; Stephen Bradley Hicks; Devin Patel; Matthew A Ciorba; Alexandra M Gutierrez; Poonam Beniwal-Patel; Sowmya Palam; Gaurav Syal; Hans H Herfarth; George Christophi; Laura Raffals; Edward L Barnes; Parakkal Deepak Journal: Inflamm Bowel Dis Date: 2019-08-20 Impact factor: 5.325
Authors: Oren Ledder; Amit Assa; Arie Levine; Johanna C Escher; Lissy de Ridder; Frank Ruemmele; Neil Shah; Ron Shaoul; Victorien M Wolters; Astor Rodrigues; Holm H Uhlig; Carsten Posovszky; Kaija-Leena Kolho; Christian Jakobsen; Shlomi Cohen; Dror S Shouval; Tim de Meij; Javier Martin-de-Carpi; Lisa Richmond; Jiri Bronsky; Mira Friedman; Dan Turner Journal: J Crohns Colitis Date: 2017-10-01 Impact factor: 9.071
Authors: William J Sandborn; Brian G Feagan; Paul Rutgeerts; Stephen Hanauer; Jean-Frédéric Colombel; Bruce E Sands; Milan Lukas; Richard N Fedorak; Scott Lee; Brian Bressler; Irving Fox; Maria Rosario; Serap Sankoh; Jing Xu; Kristin Stephens; Catherine Milch; Asit Parikh Journal: N Engl J Med Date: 2013-08-22 Impact factor: 91.245
Authors: Vince B C Biemans; C Janneke van der Woude; Gerard Dijkstra; Andrea E van der Meulen-de Jong; Mark Löwenberg; Nanne K de Boer; Bas Oldenburg; Nidhi Srivastava; Jeroen M Jansen; Alexander G L Bodelier; Rachel L West; Annemarie C de Vries; Jeoffrey J L Haans; Dirk de Jong; Frank Hoentjen; Marieke J Pierik Journal: Aliment Pharmacol Ther Date: 2020-05-22 Impact factor: 8.171
Authors: Khoon Lin Ling; Ida Hilmi; Raja Affendi Raja Ali; Rupert W L Leong; Wai Keung Leung; Siew Chien Ng; Kai Chun Wu; Min Hu Chen; Zhi Hua Ran; Tadakazu Hisamatsu; Vineet Ahuja; Govind K Makharia; Rupa Banerjee; Shu Chen Wei; Deng Chyang Wu; Pises Pisespongsa; Byong Duk Ye; Jose Sollano; Marcellus Simadibrata; Sai Wei Chuah; Choon Jin Ooi Journal: JGH Open Date: 2020-06-05