Stallmach Andreas, Schmidt Carsten, Teich Niels
a Department of Internal Medicine IV (Gastroenterology, Hepatology and Infectious Diseases) , University Hospital Jena , Jena , Germany.
b Internistische Gemeinschaftspraxis für Verdauungs- und Stoffwechselkrankheiten , Leipzig , Germany.
Expert Rev Gastroenterol Hepatol. 2016;10(2):165-75. doi: 10.1586/17474124.2016.1123618. Epub 2015 Dec 15.
A substantial proportion of patients with ulcerative colitis (UC) have failed conventional therapies such as steroids, immunosuppressants or TNF-antibodies, or have experienced side effects. This article reviews the pharmacological properties of vedolizumab (VDZ), its efficacy and side effects in UC. By its relatively specific gut-selective mode of action, VDZ's safety profile appears more favorable than that of anti-TNF therapies. VDZ is more effective than placebo for the induction and maintenance of remission in moderate-to-severe UC in both naïve patients and patients who have failed anti-TNF treatment. However, in some patients, VDZ has a slower onset of action. But, to place VDZ as a first-line therapy, it must go head-to-head with azathioprine and anti-TNF antibodies in future studies.
相当一部分溃疡性结肠炎(UC)患者对类固醇、免疫抑制剂或肿瘤坏死因子(TNF)抗体等传统疗法无效,或出现了副作用。本文综述了维多珠单抗(VDZ)的药理特性、其在UC中的疗效和副作用。由于其相对特异的肠道选择性作用模式,VDZ的安全性似乎比抗TNF疗法更具优势。在初治患者和抗TNF治疗失败的患者中,VDZ在诱导和维持中重度UC缓解方面比安慰剂更有效。然而,在一些患者中,VDZ起效较慢。但是,要将VDZ作为一线治疗药物,它必须在未来的研究中与硫唑嘌呤和抗TNF抗体进行直接比较。