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J Crohns Colitis. 2019 May 10. pii: jjz095. doi: 10.1093/ecco-jcc/jjz095. [Epub ahead of print]

Vedolizumab Treatment in Extra-Intestinal Manifestations in Inflammatory Bowel Disease: A Systematic Review.

Author information

1
Department of Hepato-Gastroenterology, University Hospital of Grenoble, University of Grenoble Alpes, Grenoble, France.
2
Department of Biomedical Sciences, Humanitas University, Milan, Italy.
3
IBD Center, Humanitas Clinical and Research Center, Milan, Italy.
4
Institut des Maladies de l'Appareil Digestif, Nantes University Hospital, Nantes, France.
5
Department of Hepato-Gastroenterology and Inserm U954, University Hospital of Nancy, University of Lorraine, Vandoeuvre-lès-Nancy, France.

Abstract

BACKGROUND AND AAIMS:

We aimed to summarize the existing data on the effectiveness of vedolizumab in extra-intestinal manifestations (EIMs) in inflammatory bowel disease (IBD).

METHODS:

We conducted a systematic literature search in PubMed and Cochrane Library, through October 2018. Interventional and non-interventional studies, as well as case-series studying vedolizumab and EIMs in adult patients with IBD, were considered eligible.

RESULTS:

Three interventional studies (one randomized trial, n=1032; and two open-label trials, n=3247), five non-interventional studies (n=1496), and three case series (n=17) were included. Vedolizumab did not show any effectiveness in primary sclerosing cholangitis (PSC). While no effect was seen in pre-existing manifestations regarding arthralgia and arthritis, the occurrence of new rheumatic symptoms was lower among vedolizumab users compared to placebo; still higher, however, with vedolizumab than with tumor necrosis factor inhibitors. Finally, vedolizumab appears not efficacious for the treatment of cutaneous manifestations.

CONCLUSIONS:

There is no strong evidence to suggest that vedolizumab may be efficacious for the treatment of pre-existing EIMs (especially PSC, rheumatic and cutaneous manifestations); however, it may reduce the occurrence of new EIMs.

KEYWORDS:

anti-integrin therapy; extraintestinal manifestations; inflammatory bowel disease; vedolizumab

PMID:
31076751
DOI:
10.1093/ecco-jcc/jjz095

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