Vedolizumab: Beyond Inflammatory Bowel Disease

Abstract

Vedolizumab (VDZ) is a key therapeutic option for inflammatory bowel disease (IBD) patients, not responding to conventional treatments. An α4β7 integrin antagonist, VDZ, primarily prevents T-cell migration to the gut by inhibiting the binding of integrins to mucosal vascular address in cellular adhesion molecule. Its gut-selective mechanism of action and safety profile makes it a valuable intervention for treating non-IBD-related diseases, which are difficult to treat and lack standardized guidelines. There is plenty of evidence to suggest that VDZ has therapeutic potential beyond its primary indication in IBD, with clinical applications now extending to immune checkpoint inhibitor-associated colitis, chronic pouchitis, gastrointestinal graft-versus-host disease, and acquired immunodeficiency syndrome. This review aimed to analyze the therapeutic value of VDZ for non-IBD-related diseases and provide a reference for treating these patients. It has been observed that long-term follow-up data are lacking, and additional well-designed large-scale studies are still needed to further validate the efficacy and safety of VDZ.

Keywords: Acquired immune deficiency syndrome; Chronic pouchitis; Gastrointestinal graft-versus-host disease; Immune checkpoint inhibitor-associated colitis; Vedolizumab.

Fig. 1.

A schematic diagram showing the mechanism of action of VDZ and related diseases. IBD, inflammatory bowel disease; ICPIs, immune checkpoint inhibitor-induced colitis; GI GVHD, gastrointestinal graft-versus-host disease; AIDS, acquired immunodeficiency syndrome; MAdCAM-1, mucosal addressin cell adhesion molecule-1.