Achieving Treatment Goals in Inflammatory Bowel Disease: The Role of Gut-Selective Therapy

Abstract

Despite major advances in the inflammatory bowel disease (IBD) treatment landscape, the management of ulcerative colitis (UC) and Crohn’s disease (CD) continues to pose challenges. There is significant scope to optimise treatment of IBD, and conventional therapies may fail to meet evolving treatment goals. Induction of remission with clinical control of symptoms and maintenance of remission with long-term prevention of disease progression are important considerations for healthcare professionals. The concept of complete remission integrates clinical remission, patient-reported outcomes, and mucosal healing, a key therapeutic goal for disease modification. The anti-integrin vedolizumab has been proven to be effective in inducing and maintaining clinical remission in IBD, both first-line and in tumour necrosis factor α (TNFα)-experienced patients, and has demonstrated mucosal healing benefits in UC patients. Safety remains critical for all therapies and vedolizumab is generally well-tolerated across all age groups, including the elderly. Real-world experience with vedolizumab has shown broadly comparable outcomes to the pivotal clinical trials.