Vedolizumab Treatment in Extra-Intestinal Manifestations in Inflammatory Bowel Disease: A Systematic Review

J Crohns Colitis. 2019 Dec 10;13(12):1569-1577. doi: 10.1093/ecco-jcc/jjz095.

Abstract

Background and aims: We aimed to summarize existing data on the effectiveness of vedolizumab in extra-intestinal manifestations [EIMs] in inflammatory bowel disease [IBD].

Methods: We conducted a systematic literature search in PubMed and the Cochrane Library, up to October 2018. Interventional and non-interventional studies as well as case-series studying vedolizumab and EIMs in adult patients with IBD were considered eligible.

Results: Three interventional studies [one randomized trial, n = 1032; and two open-label trials, n = 347], five non-interventional studies [n = 1496] and three case-series [n = 17] were included. Vedolizumab did not show any effectiveness in primary sclerosing cholangitis [PSC]. While no effect was seen in pre-existing manifestations regarding arthralgia and arthritis, the occurrence of new rheumatic symptoms was lower among vedolizumab users compared to placebo; occurrence was higher, however, with vedolizumab than with tumour necrosis factor inhibitors. Finally, vedolizumab appears not to be efficacious for the treatment of cutaneous manifestations.

Conclusions: There is no strong evidence to suggest that vedolizumab may be efficacious for the treatment of pre-existing EIMs [especially PSC, rheumatic and cutaneous manifestations], although it may reduce the occurrence of new EIMs.

Keywords: Anti-integrin therapy; extra-intestinal manifestations; inflammatory bowel disease.

Publication types

  • Systematic Review

MeSH terms

  • Antibodies, Monoclonal, Humanized / pharmacology*
  • Arthritis* / drug therapy
  • Arthritis* / etiology
  • Cholangitis, Sclerosing* / drug therapy
  • Cholangitis, Sclerosing* / etiology
  • Gastrointestinal Agents / pharmacology
  • Humans
  • Inflammatory Bowel Diseases / complications*
  • Integrins / antagonists & inhibitors
  • Skin Diseases* / drug therapy
  • Skin Diseases* / etiology
  • Treatment Outcome

Substances

  • Antibodies, Monoclonal, Humanized
  • Gastrointestinal Agents
  • Integrins
  • vedolizumab