Vedolizumab for the treatment of ulcerative colitis

Expert Rev Gastroenterol Hepatol. 2016;10(2):165-75. doi: 10.1586/17474124.2016.1123618. Epub 2015 Dec 15.

Abstract

A substantial proportion of patients with ulcerative colitis (UC) have failed conventional therapies such as steroids, immunosuppressants or TNF-antibodies, or have experienced side effects. This article reviews the pharmacological properties of vedolizumab (VDZ), its efficacy and side effects in UC. By its relatively specific gut-selective mode of action, VDZ's safety profile appears more favorable than that of anti-TNF therapies. VDZ is more effective than placebo for the induction and maintenance of remission in moderate-to-severe UC in both naïve patients and patients who have failed anti-TNF treatment. However, in some patients, VDZ has a slower onset of action. But, to place VDZ as a first-line therapy, it must go head-to-head with azathioprine and anti-TNF antibodies in future studies.

Keywords: Vedolizumab; efficacy; pharmacokinetics; side effects; ulcerative colitis.

Publication types

  • Review

MeSH terms

  • Animals
  • Anti-Inflammatory Agents / adverse effects
  • Anti-Inflammatory Agents / pharmacokinetics
  • Anti-Inflammatory Agents / therapeutic use*
  • Antibodies, Monoclonal, Humanized / adverse effects
  • Antibodies, Monoclonal, Humanized / pharmacokinetics
  • Antibodies, Monoclonal, Humanized / therapeutic use*
  • Colitis, Ulcerative / diagnosis
  • Colitis, Ulcerative / drug therapy*
  • Colitis, Ulcerative / immunology
  • Gastrointestinal Agents / adverse effects
  • Gastrointestinal Agents / pharmacokinetics
  • Gastrointestinal Agents / therapeutic use*
  • Humans
  • Integrins / antagonists & inhibitors*
  • Integrins / immunology
  • Molecular Targeted Therapy
  • Remission Induction
  • Severity of Illness Index
  • Signal Transduction / drug effects
  • Treatment Outcome

Substances

  • Anti-Inflammatory Agents
  • Antibodies, Monoclonal, Humanized
  • Gastrointestinal Agents
  • Integrins
  • integrin alpha4beta7
  • vedolizumab