2019
DOI: 10.1186/s12916-019-1323-8
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Vedolizumab trough level monitoring in inflammatory bowel disease: a state-of-the-art overview

Abstract: Background Therapeutic drug monitoring involves therapeutic modifications based on the measurement of drug levels and antidrug antibodies. The viability of therapeutic drug monitoring in vedolizumab-treated patients with inflammatory bowel disease remains questioned. Main body Accumulating evidence from clinical trials and real-world data suggests that an exposure–efficacy relationship may exist for vedolizumab in inflammatory bowel disease, but results are not as strai… Show more

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Cited by 47 publications
(34 citation statements)
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“…More recent studies have shown that, at least in UC, patients achieving and maintaining clinical and endoscopic remission have significantly higher vedolizumab trough concentration during maintenance therapy than patients who do not respond [32][33][34][35][36][37][38][39]. Nevertheless, it remains plausible that further clinical and biological factors can influence the response to the drug.…”
Section: Introductionmentioning
confidence: 99%
“…More recent studies have shown that, at least in UC, patients achieving and maintaining clinical and endoscopic remission have significantly higher vedolizumab trough concentration during maintenance therapy than patients who do not respond [32][33][34][35][36][37][38][39]. Nevertheless, it remains plausible that further clinical and biological factors can influence the response to the drug.…”
Section: Introductionmentioning
confidence: 99%
“…In these situations, endoscopic evaluation may be postponed. Recent data support early trough levels to predict mucosal healing and response to VDZ 16–19 . Other biomarkers such as undetectable soluble mucosal addressin cell adhesion molecule 1 are potential predictors 20 .…”
Section: Discussionmentioning
confidence: 93%
“…44 Indeed, real-world studies have suggested these factors to be clinically important, linking them with lower drug levels and worse therapeutic outcomes. [45][46][47] In GEMINI 1, the immunogenicity of VDZ was low; 3.7% of patients had at least one positive sample testing for anti-VDZ antibodies at any time and 1% of patients persistently tested positive for anti-VDZ antibodies. 31 This has been confirmed even in a real-world cohort using a drugresistance assay.…”
Section: Pharmacokinetics Pharmacodynamics and Immunogenicitymentioning
confidence: 99%
“…52 Pouillon et al summarized in his review using accumulating evidence from clinical trials, in addition to real-world data, suggests an exposure-efficacy relationship in the treatment of UC with VDZ, although these results are not as straightforward as those for anti-TNF-α therapy. 47 Although the exposure-outcome relationship of VDZ has been demonstrated, the time to assess the drug concentrations and the related therapeutic drug window for VDZ remains undefined. As stated by Pouillon et al, prior to the recommendation of therapeutic monitoring of VDZ, prospective studies are required to explore the effect of dose optimization on objective disease markers and changes in drug levels of VDZ.…”
Section: Pharmacokinetics Pharmacodynamics and Immunogenicitymentioning
confidence: 99%
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