Vedolizumab for the treatment of Crohn's disease

Expert Rev Clin Immunol. 2018 Mar;14(3):179-189. doi: 10.1080/1744666X.2018.1438189. Epub 2018 Feb 23.

Abstract

Crohn's disease (CD) is an immune-mediated condition characterized by inflammation of the gut tissue, associated with progressive damage of the affected intestinal tract and possible complications. A treat-to-target approach is strongly advocated, consisting of early and aggressive inflammatory control. However, a great proportion of affected subjects lack response or are intolerant to conventional therapy. Even though the first-line biologic therapy targeting tumor necrosis factor-alfa (TNF-α) is associated with improvement of inflammation in some patients, others do not respond at first or lose response over time. These findings brought about the possibility of different mechanisms being involved in perpetuating the chronic inflammatory state. Novel drugs targeting different inflammatory pathways have been studied in CD, specifically addressed to leucocyte trafficking. Areas covered: We aim to review the relevant data available in the literature and briefly summarize the efficacy and safety profile of vedolizumab in the treatment of CD. Expert commentary: Vedolizumab has shown, from pivotal and real-life data, significant clinical benefit among CD patients, in addition to a singular safety profile. Future studies will provide helpful data concerning its use in special situations.

Keywords: Crohn’s disease; Inflammatory bowel disease; biologics; treatment; vedolizumab.

Publication types

  • Review

MeSH terms

  • Animals
  • Antibodies, Monoclonal, Humanized / therapeutic use*
  • Clinical Trials as Topic
  • Crohn Disease / drug therapy*
  • Endothelium / physiology*
  • Humans
  • Immunotherapy / methods*
  • Inflammation / drug therapy*
  • Integrin alpha4 / immunology*
  • Tumor Necrosis Factor-alpha / immunology

Substances

  • Antibodies, Monoclonal, Humanized
  • Tumor Necrosis Factor-alpha
  • Integrin alpha4
  • vedolizumab