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vedolizumab crohn's

Blaise Hamel, May Wu, Elizabeth O Hamel, Dorsey M Bass, K T Park
Background: Severe colitis flare from ulcerative colitis (UC) or Crohn's disease (CD) may be refractory to corticosteroids and antitumour necrosis factor (TNF) agents resulting in high colectomy rates. We aimed to describe the utility of tacrolimus to prevent colectomy during second-line vedolizumab initiation after corticosteroid and anti-TNF treatment failure in paediatric severe colitis. Methods: A retrospective cohort analysis was performed between 1 October 2014 and 31 October 2016 at a single tertiary care centre...
2018: BMJ Open Gastroenterology
Petra Baji, László Gulácsi, Valentin Brodszky, Zsuzsanna Végh, Silvio Danese, Peter M Irving, Laurent Peyrin-Biroulet, Stefan Schreiber, Fanni Rencz, Péter L Lakatos, Márta Péntek
Background: In clinical practice, treatment sequences of biologicals are applied for active fistulising Crohn's disease, however underlying health economic analyses are lacking. Objective: The purpose of this study was to analyse the cost-effectiveness of different biological sequences including infliximab, biosimilar-infliximab, adalimumab and vedolizumab in nine European countries. Methods: A Markov model was developed to compare treatment sequences of one, two and three biologicals from the payer's perspective on a five-year time horizon...
March 2018: United European Gastroenterology Journal
Amy L Lightner, Kellie L Mathis, Chung Sang Tse, John H Pemberton, Bo Shen, Gursimran Kochlar, Amandeep Singh, Parambir S Dulai, Samuel Eisenstein, William J Sandborn, Lisa Parry, Sarah Stringfield, David Hudesman, Feza Remzi, Edward V Loftus
Background: Vedolizumab is now widely available for the treatment of moderate to severe ulcerative colitis (UC) and Crohn's disease (CD). We sought to quantify the rates of postoperative complications with preoperative vedolizumab compared with anti-tumor necrosis factor (anti-TNF) therapy. Methods: A multicenter retrospective review of adult inflammatory bowel disease (IBD) patients who underwent an abdominal operation between May 20, 2014, and December 31, 2015, was performed...
March 2, 2018: Inflammatory Bowel Diseases
Mark Fleisher, Jan Marsal, Scott D Lee, Laura E Frado, Alyssa Parian, Burton I Korelitz, Brian G Feagan
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...
February 26, 2018: Digestive Diseases and Sciences
Robert P Hirten, Marietta Iacucci, Shailja Shah, Subrata Ghosh, Jean-Frederic Colombel
Current therapies used in the treatment of inflammatory bowel disease (IBD) are not effective in all patients. Biologic agents result in approximately 40% remission rates at 1 year in selected populations, prompting a growing interest in combining biologic therapy to improve outcomes. There are limited published data regarding the efficacy and safety of combination targeted therapy in IBD specifically, which include only one exploratory randomized control trial and three case reports or series. This review evaluates the published literature regarding this therapeutic paradigm in IBD and its extensive utilization in the treatment of other immune-mediated inflammatory disorders...
February 23, 2018: Clinical Gastroenterology and Hepatology
Geom Seog Seo, Sung Hee Lee
The treatment of inflammatory bowel disease has evolved with the development of anti-TNF agents. In spite of long-term effectiveness, many patients do not respond or no longer responds to these drugs. Therefore, the development of new drugs that act on different inflammatory pathways has become necessary. Vedolizumab, a gut-specific biological agent, inhibits interaction α4β7 integrin with mucosal addressin cell adhesion molecule-1 without inhibiting systemic immune responses. Long-term vedolizumab therapy in patients with Crohn's disease and ulcerative colitis was safe and effective...
February 25, 2018: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
Brian G Feagan, David Schwartz, Silvio Danese, David T Rubin, Trevor W Lissoos, Jing Xu, Karen Lasch
Background and Aims: Medical management of fistulising Crohn's disease (CD) is constrained by the limited number of available therapies. We evaluated the efficacy of vedolizumab, a gut-selective α4β7 integrin antagonist approved for treating moderately to severely active CD, in a subpopulation of patients with fistulising CD who participated in the GEMINI 2 trial (NCT00783692). Methods: Exploratory analyses of data from the GEMINI 2 trial were conducted in 461 responders to 6-week vedolizumab induction therapy who received maintenance placebo (VDZ/PBO, N=153) or vedolizumab (VDZ/VDZ, N=308)...
February 17, 2018: Journal of Crohn's & Colitis
Steven Bots, Krisztina Gecse, Murray Barclay, Geert D'Haens
Whether to use biologic treatment for inflammatory bowel disease as monotherapy or in combination with immunosuppressives has been a matter of debate in the last 2 decades. Combination therapy was not superior in any of the registration trials for Crohn's disease and ulcerative colitis for TNF antagonists, vedolizumab, or ustekinumab. It needs to be mentioned, though, that none of these trials were powered to detect such differences, and that many patients entered the trial after having failed conventional immunosuppressives...
February 15, 2018: Inflammatory Bowel Diseases
Akihiro Yamada, Yuga Komaki, Nayan Patel, Fukiko Komaki, Joel Pekow, Sushila Dalal, Russell D Cohen, Lisa Cannon, Konstantin Umanskiy, Radhika Smith, Roger Hurst, Neil Hyman, David T Rubin, Atsushi Sakuraba
Background: Clinical and endoscopic recurrence are common after surgery in Crohn's disease (CD). Vedolizumab has been increasingly used to treat CD, however, its effectiveness in preventing postoperative recurrence remains unknown. We aimed to investigate the use of vedolizumab in the postoperative setting and compare the risk of recurrence between patients receiving vedolizumab and anti-tumor necrosis factor (TNF)-α agents. Methods: Medical records of CD patients who underwent surgery between April 2014 and June 2016 were reviewed...
February 15, 2018: Inflammatory Bowel Diseases
A Barré, J-F Colombel, R Ungaro
BACKGROUND: Increased knowledge of pathways involved in the pathogenesis of IBD has led to the development of new treatment options for Crohn's disease (CD) and ulcerative colitis (UC). Two new biological agents have been recently approved for IBD: vedolizumab and ustekinumab. They have different therapeutic targets (α4 β7 integrin for vedolizumab and interleukin-12/23 pathways for ustekinumab) than the primary biological class, anti-tumour necrosis factor alpha (anti-TNF) agents. As the armamentarium for IBD increases in coming years, it will become important to understand factors associated with response in order to best position and personalise therapy...
February 12, 2018: Alimentary Pharmacology & Therapeutics
Marjorie Argollo, Gionata Fiorino, Laurent Peyrin-Biroulet, Silvio Danese
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...
February 6, 2018: Expert Review of Clinical Immunology
Maria Rosario, Jonathan L French, Nathanael L Dirks, Serap Sankoh, Asit Parikh, Huyuan Yang, Silvio Danese, Jean-Frédéric Colombel, Michael Smyth, William J Sandborn, Brian G Feagan, Walter Reinisch, Bruce E Sands, Miguel Sans, Irving Fox
No abstract text is available yet for this article.
January 29, 2018: Journal of Crohn's & Colitis
Séverine Vermeire, Ann Gils, Paola Accossato, Sadiq Lula, Amy Marren
Crohn's disease and ulcerative colitis are chronic inflammatory disorders of the gastrointestinal tract. Treatment options include biologic therapies; however, a proportion of patients lose response to biologics, partly due to the formation of anti-drug antibodies (ADAbs). Concomitant immunosuppressive agents reduce the development of ADAbs. This review article aims to assess the immunogenicity of biologic therapies and their clinical implications. A comprehensive literature search was conducted for articles published January 2009 to August 2015 reporting immunogenicity to adalimumab (ADM), certolizumab pegol (CZP), golimumab, infliximab (IFX), ustekinumab, and vedolizumab in inflammatory bowel disease (IBD)...
2018: Therapeutic Advances in Gastroenterology
B Christensen, D Micic, P R Gibson, A Yarur, E Bellaguarda, P Corsello, J N Gaetano, J Kinnucan, V L Rao, S Reddy, S Singh, J Pekow, D T Rubin
BACKGROUND: Blocking of lymphocyte trafficking to bile ducts is a potential mechanism to alter the disease course of patients with primary sclerosing cholangitis (PSC). AIM: To describe the effect of the α4 β7 integrin antibody, vedolizumab, on liver biochemistry and disease activity in patients with PSC and inflammatory bowel disease (IBD). METHODS: This is a retrospective multi-centre study of adult patients with a diagnosis of both IBD and PSC...
January 29, 2018: Alimentary Pharmacology & Therapeutics
Matthew J Lee, Claire E Parker, Sarah R Taylor, Leonardo Guizzetti, Brian G Feagan, Alan J Lobo, Vipul Jairath
BACKGROUND & AIMS: Fistulas are debilitating complications of Crohn's disease (CD) that affect up to 50% of patients. We conducted a systematic review and meta-analysis of randomized controlled trials to assess the efficacy of treatments for fistulizing CD. METHODS: We searched publication databases from inception through December 13, 2016 for trials comparing the efficacy of a therapeutic agent (single or combination) with placebo or another active therapy in adult patients with any form of fistulizing CD...
January 25, 2018: Clinical Gastroenterology and Hepatology
Elisa K Boden, Donna M Shows, Michael V Chiorean, James D Lord
BACKGROUND/AIMS: Vedolizumab is an anti-α4β7 monoclonal antibody approved for the treatment of inflammatory bowel disease (IBD). This exploratory study aimed to identify biomarkers associated with vedolizumab response. METHODS: Twenty-six IBD patients (15 with Crohn's, 11 with ulcerative or indeterminate colitis) initiating vedolizumab at a single center between 2014 and 2016 underwent sampling of serum and peripheral blood mononuclear cells (PBMCs) before and during vedolizumab therapy...
January 25, 2018: Digestive Diseases and Sciences
Lori A Zimmerman, Jill M Zalieckas, Robert C Shamberger, Athos Bousvaros
BACKGROUND: Vedolizumab is a biologic, which inhibits leukocyte adhesion in the gut and is used to treat ulcerative colitis (UC) and Crohn's disease (CD). Little is known of the surgical outcomes in patients treated with vedolizumab. We reviewed the postoperative complications in a cohort of pediatric UC and CD patients treated with vedolizumab. METHODS: We identified pediatric UC and CD patients treated with vedolizumab at our institution from 2014 to 2016. We compared postoperative outcomes in the vedolizumab exposed group to a cohort of vedolizumab naïve patients who required diverting ileostomy...
December 16, 2017: Journal of Pediatric Surgery
Ruediger S Goertz, Daniel Klett, Dane Wildner, Raja Atreya, Markus F Neurath, Deike Strobel
Background Microvascularization of the bowel wall can be visualized and quantified non-invasively by software-assisted analysis of derived time-intensity curves. Purpose To perform software-based quantification of bowel wall perfusion using quantitative contrast-enhanced ultrasound (CEUS) according to clinical response in patients with inflammatory bowel disease treated with vedolizumab. Material and Methods In a prospective study, in 18 out of 34 patients, high-frequency ultrasound of bowel wall thickness using color Doppler flow combined with CEUS was performed at baseline and after 14 weeks of treatment with vedolizumab...
January 1, 2018: Acta Radiologica
Donata Lissner, Rainer Glauben, Kristina Allers, Elena Sonnenberg, Christoph Loddenkemper, Thomas Schneider, Britta Siegmund
No abstract text is available yet for this article.
January 2018: American Journal of Gastroenterology
Tero Ylisaukko-Oja, Jaakko Aaltonen, Heikki Nuutinen, Timo Blomster, Airi Jussila, Markku Pajala, Kimmo Salminen, Veikko Moilanen, Kalle Hakala, Mikko Kellokumpu, Kari Toljamo, Henna Rautiainen, Juha Kuisma, Markku Peräaho, Pauliina Molander, Jouni Silvennoinen, Ville Liukkonen, Hans Henricson, Jyrki Tillonen, Mirva Esterinen, Christian Nielsen, Eija Hirsi, Margus Lääne, Ulla-Maija Suhonen, Ilkka Vihriälä, Petri Mäkelä, Mika Puhto, Jari Punkkinen, Hannu Sulonen, Sauli Herrala, Jari Jokelainen, Klaus Tamminen, Taina Sipponen
OBJECTIVES: The efficacy and tolerability of vedolizumab in the treatment of inflammatory bowel diseases (IBD) has been demonstrated in an extensive GEMINI clinical trial programme. Clinical trials represent highly selected patient populations and, therefore, it is important to demonstrate effectiveness in real-life clinical practice. We set out to assess real-world treatment outcomes of vedolizumab in a nationwide cohort of treatment refractory Finnish Crohn's disease (CD) and ulcerative colitis (UC) patients...
December 19, 2017: Scandinavian Journal of Gastroenterology
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