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Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jun 21, 2018; 24(23): 2457-2467
Published online Jun 21, 2018. doi: 10.3748/wjg.v24.i23.2457
Vedolizumab for inflammatory bowel disease: From randomized controlled trials to real-life evidence
Maria Lia Scribano
Maria Lia Scribano, IBD Unit, Azienda Ospedaliera San Camillo-Forlanini, Rome 00152, Italy
Author contributions: Scribano ML solely contributed to this paper.
Conflict-of-interest statement: Advisory board member and/or speaker for Abbvie, Biogen Idec, Janssen, Mundipharma, Pfizer, and Takeda.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Maria Lia Scribano, MD, IBD Unit, Azienda Ospedaliera San Camillo-Forlanini, Circonvallazione Gianicolense, 87, Rome 00152, Italy. marialiascribano@virgilio.it
Telephone: +39-6-58703308 Fax: +39-6-58704328
Received: April 16, 2018
Peer-review started: April 18, 2018
First decision: April 27, 2018
Revised: May 6, 2018
Accepted: May 18, 2018
Article in press: May 18, 2018
Published online: June 21, 2018
Abstract

The biologic antitumor necrosis factor alpha (anti-TNFα) agents have revolutionised the treatment of inflammatory bowel disease (IBD). However, some patients experience primary nonresponse, loss of response, or intolerance. Therefore, introducing a newer class of therapy with a mechanism of action that acts on different inflammatory pathways involved in IBD pathogenesis is appealing. Vedolizumab is a fully humanised monoclonal antibody that selectively targets α4β7 integrin. Based on the results of the pivotal clinical GEMINI trials, vedolizumab was approved for the treatment of adult patients with moderately to severely active ulcerative colitis (UC) and Crohn’s disease (CD) refractory or intolerant to either conventional therapy or TNFα inhibitors. This review describes the efficacy, safety, and tolerability of vedolizumab reported in both randomized, controlled, clinical trials and from real-world experience in patients with UC and CD in order to identify its place in treatment algorithms for IBD.

Keywords: Vedolizumab, Crohn’s disease, Real-world, Efficacy, Ulcerative colitis, Controlled trial, Effectiveness, Safety

Core tip: Vedolizumab represents an interesting new therapeutic option for the treatment of patients with moderate-to-severe ulcerative colitis and Crohn’s disease that are refractory or intolerant to either conventional treatments or anti-TNFα agents. This review describes the efficacy, safety, and tolerability of vedolizumab demonstrated in the clinical GEMINI trials. In addition, the paper reviews the effectiveness and the safety of vedolizumab in the real-world studies in order to identify its place in treatment algorithms for patients with inflammatory bowel disease.