Vedolizumab for inflammatory bowel disease: From randomized controlled trials to real-life evidence

Scribano, Maria Lia

doi:10.3748/wjg.v24.i23.2457

Cited by 73 publications

(61 citation statements)

References 57 publications

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“…Via selective inhibition of the interaction between α4β7 integrin and mucosal addressin cell adhesion molecule-1 (MAdCAM-1), vedolizumab inhibits the leukocyte binding to endothelial surface and its extravasation into inflamed GI parenchymal tissue. Both of these new therapeutic options appear to be associated with rapid and sustained clinical effect, paralleled by a favorable safety profile, dampening of the inflammatory cascade, and lack of immunogenicity (26)(27). The recovery of skin lesions in MCD is variable and does not parallel that of intestinal lesions.…”

Section: Discussionmentioning

confidence: 99%

Metastatic vulvar Crohn’s disease preceding intestinal manifestations: a case report and short review

Kyriakou¹,

Gkermpesi²,

Thomopoulos³

et al. 2019

Acta Dermatovenerologica Alpina Pannonica Et Adriatica

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Crohn's disease (CD) is a multi-systemic chronic granulomatous inflammatory disease with a constellation of extraintestinal manifestations affecting various organs, including the skin. Metastatic CD (MCD), defined as granulomatous lesions of the skin occurring at sites separate from the gastrointestinal (GI) tract in patients affected with CD, is the least common cutaneous manifestation, and it is occasionally the primary manifestation of the disease. It may precede any symptoms from the GI tract by months or even years, and it often remains undiagnosed. We present the case of a 42-year-old woman with a rare cutaneous manifestation of MCD involving the external genitalia. The cutaneous lesions of the mons pubis and vulva preceded GI manifestations of CD by 2 years. The patient was treated with azathioprine, oral steroids, and antibiotics. Reduction of the cutaneous nodules, discharge, and erythema was achieved, accompanied by relief of GI symptoms. Response to treatment was maintained during a follow-up of 6 months. In MCD, involvement of the external genitalia is exceedingly rare, with few documented cases in the literature. The integration of clinical information, microscopic findings, and exclusion of other cutaneous granulomatous processes is necessary in order to accurately diagnose this rare dermatologic entity and provide an opportunity for successful therapeutic intervention.

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Section: Discussionmentioning

confidence: 99%

Metastatic vulvar Crohn’s disease preceding intestinal manifestations: a case report and short review

Kyriakou¹,

Gkermpesi²,

Thomopoulos³

et al. 2019

Acta Dermatovenerologica Alpina Pannonica Et Adriatica

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“…In contrast to other anti-adhesion drugs, the use of vedolizumab in UC patients did not increase the rates of opportunistic or enteric infections and there were no reported cases of progressive multifocal leukoencephalopathy [53]. Following encouraging results in randomized, double-blind, placebo-controlled trials in the pivotal phase III GEMINI studies, vedolizumab has been approved by US FDA for the treatment of adult patients with active UC who had a poor response to standard therapies [54]. Nevertheless, mononuclear phagocyte enrichment was detected in non-responder UC patients before vedolizumab treatment, which further increased post treatment [52], partly explaining why some UC patients do not respond as well to this drug.…”

Section: The Role Of Biomarkers and Treatment Options In Ucmentioning

confidence: 99%

Ulcerative colitis: understanding its cellular pathology could provide insights into novel therapies

Kaur

Goggolidou

2020

J Inflamm

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Dynamic interactions between the gastrointestinal epithelium and the mucosal immune system normally contribute to ensuring intestinal homeostasis and optimal immunosurveillance, but destabilisation of these interactions in genetically predisposed individuals can lead to the development of chronic inflammatory diseases. Ulcerative colitis is one of the main types of inflammatory diseases that affect the bowel, but its pathogenesis has yet to be completely defined. Several genetic factors and other inflammation-related genes are implicated in mediating the inflammation and development of the disease. Some susceptibility loci associated with increased risk of ulcerative colitis are found to be implicated in mucosal barrier function. Different biomarkers that cause damage to the colonic mucosa can be detected in patients, including perinuclear ANCA, which is also useful in distinguishing ulcerative colitis from other colitides. The choice of treatment for ulcerative colitis depends on disease severity. Therapeutic strategies include anti-tumour necrosis factor alpha (TNF-α) monoclonal antibodies used to block the production of TNF-α that mediates intestinal tract inflammation, an anti-adhesion drug that prevents lymphocyte infiltration from the blood into the inflamed gut, inhibitors of JAK1 and JAK3 that suppress the innate immune cell signalling and interferons α/β which stimulate the production of anti-inflammatory cytokines, as well as faecal microbiota transplantation. Although further research is still required to fully dissect the pathophysiology of ulcerative colitis, understanding its cellular pathology and molecular mechanisms has already proven beneficial and it has got the potential to identify further novel, effective targets for therapy and reduce the burden of this chronic disease.

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“…In addition, drug treatments with a mechanism of action similar to that of blood cell apheresis have emerged. Vedolizumab, a mAb that targets a4b7 integrins, exerting in a gut-selective mechanism of action, has emerged for the induction of remission in active IBD patients [44]. Based on clinical trials and actual clinical data, vedolizumab is expected to be effective in treating patients who are resistant to anti-TNF-a antibody treatment [45].…”

Section: Ibd Treatment From the Perspective Of The Adaptive Immune Symentioning

confidence: 99%

Treatment of inflammatory bowel disease from the immunological perspective

Nakase

2020

Immunological Medicine

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Since 1950, the number of patients with inflammatory bowel disease (IBD) in Japan has been increasing. Recent research data indicate that the pathophysiology of IBD involves abnormalities in disease susceptibility genes, environmental factors and intestinal bacteria. The elucidation of the mechanism of IBD has facilitated therapeutic development based on basic research data. In particular, the emergence of biologics has brought about a paradigm shift in the treatment of IBD. However, there are still IBD patients who are refractory to these biologics. IBD pathophysiology is extremely complex. Therefore, to address these clinical issues, further clinical and basic data are required. The bottom line of IBD drug therapy is still to use the most of recent treatments. Therefore, the physicians should be familiar with the modes of action (MOA) of the available drugs.

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Vedolizumab for inflammatory bowel disease: From randomized controlled trials to real-life evidence

Cited by 73 publications

References 57 publications

Metastatic vulvar Crohn’s disease preceding intestinal manifestations: a case report and short review

Metastatic vulvar Crohn’s disease preceding intestinal manifestations: a case report and short review

Ulcerative colitis: understanding its cellular pathology could provide insights into novel therapies

Treatment of inflammatory bowel disease from the immunological perspective

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