Gisbert Javier P, Domènech Eugeni
Servicio de Aparato Digestivo, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP) y Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, España.
Servicio de Aparato Digestivo, Hospital Universitari Germans Trias i Pujol y CIBEREHD, Badalona, España.
Gastroenterol Hepatol. 2015 May;38(5):338-48. doi: 10.1016/j.gastrohep.2014.12.003. Epub 2015 Jan 23.
The anti-TNFα agents, infliximab and adalimumab, are effective in the treatment of Crohn's disease. Nevertheless, approximately one-third of patients do not initially respond to treatment and a substantial proportion experience loss of efficacy or intolerance to these drugs. Therefore, new drugs are obviously required, aimed at therapeutic targets other than TNFα. Notable among the therapeutic alternatives are drugs targeting integrins. Vedolizumab is a humanized monoclonal antibody that binds specifically to the α4β7 integrin, inhibiting T lymphocytes from binding to adhesion molecules (MAdCAM-1), which are expressed mainly in the small bowel and colon. Consequently, and unlike natalizumab, vedolizumab can be considered a specific intestinal immunosuppressant, making it especially attractive. The present article reviews the role of vedolizumab in Crohn's disease, paying special attention to its pharmacokinetic/pharmacodynamic properties, indications, effectiveness, and safety.
抗TNFα药物英夫利昔单抗和阿达木单抗在治疗克罗恩病方面有效。然而，约三分之一的患者最初对治疗无反应，且相当一部分患者出现疗效丧失或对这些药物不耐受。因此，显然需要针对TNFα以外治疗靶点的新药。治疗替代方案中值得注意的是靶向整合素的药物。维多珠单抗是一种人源化单克隆抗体，可特异性结合α4β7整合素，抑制T淋巴细胞与主要在小肠和结肠表达的黏附分子（黏膜地址素细胞黏附分子-1，MAdCAM-1）结合。因此，与那他珠单抗不同，维多珠单抗可被视为一种特异性肠道免疫抑制剂，这使其特别具有吸引力。本文综述了维多珠单抗在克罗恩病中的作用，特别关注其药代动力学/药效学特性、适应证、有效性和安全性。
