Successful long-term treatment of paediatric ulcerative colitis with vedolizumab: a case report

Eur J Hosp Pharm. 2023 Nov;30(6):e30. doi: 10.1136/ejhpharm-2022-003434. Epub 2022 Dec 9.

Abstract

Biologics are recommended to treat paediatric ulcerative colitis (UC) that is chronically active or steroid-dependent despite aminosalicylic acids (5-ASA) and thiopurine treatments. Anti-tumour necrosis factor inhibitors (Anti-TNF inhibitors) are the agents of choice and vedolizumab could be considered as second-line biologic therapy.In the current case, we aim to describe a successful long-term treatment with vedolizumab in a 9-year-old boy with severe UC and primary non-response to infliximab. Concomitant azathioprine was used, and steroid refractoriness was also detected. Drug and anti-drug antibody levels were negative after infliximab induction so a switch to a 6-week-induction vedolizumab regimen followed by a maintenance regimen as a monotherapy was decided. The clinical response and tolerability to vedolizumab allowed long-term disease remission. Vedolizumab is currently non-authorised to treat paediatric patients and there is limited data on long-term treatments to date. This case contributes to the literature by adding evidence on the long-term efficacy and safety of vedolizumab in paediatric UC.

Keywords: Case Reports; GASTROENTEROLOGY; Inflammatory Bowel Diseases; PEDIATRICS; Safety.

Publication types

  • Case Reports

MeSH terms

  • Child
  • Humans
  • Infliximab / therapeutic use
  • Male
  • Steroids*
  • Tumor Necrosis Factor Inhibitors*

Substances

  • vedolizumab
  • Infliximab
  • Tumor Necrosis Factor Inhibitors
  • Steroids

Supplementary concepts

  • Pediatric ulcerative colitis