A product review of vedolizumab in inflammatory bowel disease.
Robert BattatParambir S DulaiVipul JairathNiels Vande CasteelePublished in: Human vaccines & immunotherapeutics (2019)
Vedolizumab is a monoclonal antibody to the α4β7 integrin that selectively reduces intestinal lymphocyte trafficking, thereby providing a safe and effective treatment option for patients with inflammatory bowel disease (IBD). This product review outlines the unique mechanism of vedolizumab in addition to efficacy, safety, pharmacokinetic and pharmacodynamic data from clinical trials, observational studies and meta-analyses. Vedolizumab has been shown to be effective as a first- or second-line induction and maintenance therapy in both ulcerative colitis (UC) and Crohn's disease (CD). Prolonged induction therapy may increase efficacy, particularly in tumor necrosis factor-alpha-exposed CD patients. To date, no drug-specific safety signals have been identified. In addition to the presence of an apparent exposure-response relationship, vedolizumab has demonstrated consistent pharmacodynamic effects on α4β7, mucosal vascular addressin cell adhesion molecule 1 and other cell adhesion molecules. Future efforts should focus on identifying predictive biomarkers capable of guiding personalized IBD treatment with vedolizumab.
Keyphrases
- ulcerative colitis
- patients with inflammatory bowel disease
- cell adhesion
- clinical trial
- monoclonal antibody
- end stage renal disease
- meta analyses
- rheumatoid arthritis
- ejection fraction
- newly diagnosed
- chronic kidney disease
- peritoneal dialysis
- randomized controlled trial
- emergency department
- combination therapy
- machine learning
- quality improvement
- diffusion weighted imaging
- replacement therapy
- phase ii
- patient reported
- study protocol
- nk cells