Effects of Vedolizumab Therapy on Extraintestinal Manifestations in Inflammatory Bowel Disease

Dig Dis Sci. 2018 Apr;63(4):825-833. doi: 10.1007/s10620-018-4971-1. Epub 2018 Feb 26.

Abstract

Background: Approximately 15-20% of ulcerative colitis patients and 20-40% of those with Crohn's disease experience extraintestinal manifestations (EIMs) of their inflammatory bowel disease (IBD). Clinicians who treat IBD must manage EIMs affecting multiple organs that variably correlate with intestinal disease activity. Vedolizumab is a monoclonal antibody for the treatment of IBD with a gut-selective mechanism of action.

Aims: This report evaluates whether vedolizumab is an effective treatment of EIMs, given its gut-specific mechanism of action.

Methods: We report 8 case studies of patients with various EIMs, including pyoderma gangrenosum, peripheral arthralgia/arthritis, axial arthropathies, erythema nodosum, and uveitis, who received vedolizumab therapy.

Results: Vedolizumab therapy was effective for pyoderma gangrenosum in ulcerative colitis, uveitis, erythema nodosum, polyarticular arthropathy, and ankylosing spondylitis/sacroiliitis but did not provide sustained benefit for the treatment of pyoderma gangrenosum in a patient with Crohn's disease.

Conclusions: These cases demonstrate the potential of vedolizumab as a treatment of EIMs in patients with IBD.

Keywords: Crohn’s disease; Extraintestinal manifestations; Inflammatory bowel disease; Ulcerative colitis.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adolescent
  • Adult
  • Aged, 80 and over
  • Antibodies, Monoclonal, Humanized / therapeutic use*
  • Female
  • Gastrointestinal Agents / therapeutic use*
  • Humans
  • Inflammatory Bowel Diseases / complications*
  • Inflammatory Bowel Diseases / drug therapy*
  • Male
  • Middle Aged
  • Young Adult

Substances

  • Antibodies, Monoclonal, Humanized
  • Gastrointestinal Agents
  • vedolizumab