Department of Hepato-Gastroenterology, University Hospital of Grenoble, University of Grenoble Alpes, Grenoble, France.
Department of Biomedical Sciences, Humanitas University, Milan, Italy.
J Crohns Colitis. 2019 Dec 10;13(12):1569-1577. doi: 10.1093/ecco-jcc/jjz095.
We aimed to summarize existing data on the effectiveness of vedolizumab in extra-intestinal manifestations [EIMs] in inflammatory bowel disease [IBD].
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.
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.
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.
我们旨在总结现有关于 vedolizumab 在炎症性肠病（IBD）的肠外表现（EIMs）中的疗效的数据。
我们在 PubMed 和 Cochrane 图书馆进行了系统的文献检索，截至 2018 年 10 月。研究 vedolizumab 和 IBD 成年患者 EIMs 的干预性和非干预性研究以及病例系列研究被认为符合条件。
共纳入 3 项干预性研究[1 项随机试验，n = 1032；2 项开放标签试验，n = 347]、5 项非干预性研究[n = 1496]和 3 项病例系列研究[n = 17]。vedolizumab 在原发性硬化性胆管炎（PSC）中没有显示出任何疗效。虽然在关节炎和关节炎的预先存在的表现中没有看到效果，但与安慰剂相比，vedolizumab 使用者的新风湿症状发生较低；然而，与肿瘤坏死因子抑制剂相比，vedolizumab 的发生率更高。最后，vedolizumab 似乎对治疗皮肤表现无效。
没有强有力的证据表明 vedolizumab 可能对治疗预先存在的 EIMs[特别是 PSC、风湿和皮肤表现]有效，尽管它可能会减少新 EIMs 的发生。
