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

Effects of Vedolizumab Therapy on Extraintestinal Manifestations in Inflammatory Bowel Disease

Mark Fleisher  1 , Jan Marsal  2 , Scott D Lee  3 , Laura E Frado  4 , Alyssa Parian  5 , Burton I Korelitz  6 , Brian G Feagan  7
Affiliations
Review

Effects of Vedolizumab Therapy on Extraintestinal Manifestations in Inflammatory Bowel Disease

Mark Fleisher et al. Dig Dis Sci. 2018 Apr.

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.

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Conflict of interest statement

Conflict of interest

Dr. Feagan has received grant support from AbbVie, Amgen, AstraZeneca, Bristol-Myers Squibb, Roche, Genentech, J&J, Janssen, Millennium, Pfizer, Receptos, Tillotts, and UCB and served as a consultant or advisory board member for AbbVie, ActoGeniX, Akros, Albireo, Amgen, AstraZeneca, Avaxia Biologics, Avir Pharma, Baxter Healthcare Corp, Biogen Idec, Boehringer Ingelheim, Bristol-Myers Squibb, Calypso Biotech, Celgene, Elan/Biogen, enGene, Ferring Pharmaceuticals, Galapagos, Genentech/Roche, GiCare Pharma, Gilead, Given Imaging, GSK, Inception IBD Inc, Ironwood Pharmaceuticals, J&J, Janssen, Japan Tobacco, Kyowa Hakko Kirin Co Ltd, Lexicon, Lilly, Lycera Biotech, Merck, Mesoblast Ltd, Millennium, Nektar, Nestlé, Novartis, Novo Nordisk, Pfizer, Prometheus Therapeutics & Diagnostics, Protagonist, Receptos, Salix, Shire, Sigmoid Pharma, Synergy Pharmaceuticals Inc, Takeda, Teva Pharmaceutical Industries Ltd, TiGenix, Tillotts, UCB Pharma, Vertex Pharmaceuticals, VHsquared Ltd, Warner Chilcott, Wyeth, Zealand Pharma, and Zyngenia. Dr. Marsal has received grants from the Healthcare Region of Southern Sweden, Skane University Hospital, and the Swedish government; grants and personal fees from Abbvie, Ferring, Hospira; and personal fees from Bristol-Myers Squibb, Takeda and Tillotts. Dr. Lee has received grant and research support from AbbVie, Arena, Atlantic, Celgene, Gilead Sciences, Janssen, Pfizer, Salix, Shield, Takeda, Tetherex, UCB Pharma and has performed consulting for Arena, Celgene, Celltrion Healthcare, Cornerstones, Eli Lilly and Company, Janssen, Mesoblast, Pfizer, Salix, Takeda, and UCB Pharma. Dr. Fleisher has served on the speaker bureau for Janssen and Takeda. Drs. Korelitz, Frado, and Parian have nothing to disclose.

Informed consent

A written informed consent was obtained from patient cases 1, 2, 3, 4, 5, 6, and 8. Case 7 was de-identified and was in compliance with University of Washington Medical Center’s IRB, which does not require an informed consent for single case reports of de-identified patients.

Figures

Fig. 1
Fig. 1
MRI findings of the 50-year-old male in case 1 before treatment. Arrows in the axial MR image of the sacroiliac joints indicate articular irregularities and periarticular edema as signs of sacroiliitis
See this image and copyright information in PMC

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