Borland-Groover Clinic, Jacksonville, FL, USA.
Lund University, Lund, Sweden.
Dig Dis Sci. 2018 Apr;63(4):825-833. doi: 10.1007/s10620-018-4971-1. Epub 2018 Feb 26.
Approximately 15-20% of ulcerative colitis patients and 20-40% of those with Crohn's disease experience extraintestinal manifestations (EIMs) of their inflammatory bowel disease (IBD). Clinicians who treat IBD must manage EIMs affecting multiple organs that variably correlate with intestinal disease activity. Vedolizumab is a monoclonal antibody for the treatment of IBD with a gut-selective mechanism of action.
This report evaluates whether vedolizumab is an effective treatment of EIMs, given its gut-specific mechanism of action.
We report 8 case studies of patients with various EIMs, including pyoderma gangrenosum, peripheral arthralgia/arthritis, axial arthropathies, erythema nodosum, and uveitis, who received vedolizumab therapy.
Vedolizumab therapy was effective for pyoderma gangrenosum in ulcerative colitis, uveitis, erythema nodosum, polyarticular arthropathy, and ankylosing spondylitis/sacroiliitis but did not provide sustained benefit for the treatment of pyoderma gangrenosum in a patient with Crohn's disease.
These cases demonstrate the potential of vedolizumab as a treatment of EIMs in patients with IBD.
大约 15-20%的溃疡性结肠炎患者和 20-40%的克罗恩病患者会出现炎症性肠病(IBD)的肠外表现(EIMs)。治疗 IBD 的临床医生必须管理影响多个器官的 EIMs,这些器官的活动与肠道疾病的活动程度不同。Vedolizumab 是一种用于治疗 IBD 的单克隆抗体,具有肠道选择性的作用机制。
鉴于其肠道特异性作用机制,本报告评估了 Vedolizumab 治疗 EIMs 的效果。
我们报告了 8 例患有各种 EIMs 的患者的病例研究,包括坏疽性脓皮病、外周关节痛/关节炎、轴性关节炎、结节性红斑和葡萄膜炎,这些患者接受了 Vedolizumab 治疗。
Vedolizumab 治疗对溃疡性结肠炎、葡萄膜炎、结节性红斑、多关节病和强直性脊柱炎/骶髂关节炎中的坏疽性脓皮病有效,但对克罗恩病患者的坏疽性脓皮病治疗没有持续获益。
这些病例表明,Vedolizumab 可能是治疗 IBD 患者 EIMs 的一种方法。