Groudan Kevin, Gupta Kamesh, Singhania Rohit
Internal Medicine, Baystate Medical Center, Springfield, USA.
Gastroenterology, Baystate Medical Center, Springfield, USA.
Cureus. 2021 Jan 8;13(1):e12582. doi: 10.7759/cureus.12582.
Vedolizumab is a humanized monoclonal integrin blocker with gut selective effects on lymphocyte trafficking. Its efficacy and safety for the treatment of moderate to severe Crohn's disease and ulcerative colitis were demonstrated by phase III GEMINI studies (GEMINI 1 trial: Vedolizumab as Induction and Maintenance Therapy for Ulcerative Colitis; GEMINI 2 trial: Vedolizumab as Induction and Maintenance Therapy for Crohn's Disease). Post hoc analyses of the GEMINI studies further showed the potential benefit of vedolizumab for treating various extraintestinal manifestations, including arthralgias, pyoderma gangrenosum, erythema nodosum, and uveitis. However, findings lacked statistical significance highlighting the need for more clinical data describing vedolizumab's effects on extraintestinal manifestations. There are currently few case reports describing the effect of vedolizumab on pyoderma gangrenosum specifically. We report a Crohn's disease patient whose severe pyoderma gangrenosum of her legs, abdomen, and face have been inactive since starting vedolizumab.
维多珠单抗是一种人源化单克隆整合素阻滞剂,对淋巴细胞转运具有肠道选择性作用。III期GEMINI研究(GEMINI 1试验:维多珠单抗作为溃疡性结肠炎的诱导和维持治疗;GEMINI 2试验:维多珠单抗作为克罗恩病的诱导和维持治疗)证明了其治疗中度至重度克罗恩病和溃疡性结肠炎的有效性和安全性。GEMINI研究的事后分析进一步显示了维多珠单抗治疗各种肠外表现(包括关节痛、坏疽性脓皮病、结节性红斑和葡萄膜炎)的潜在益处。然而,研究结果缺乏统计学意义,这突出表明需要更多描述维多珠单抗对肠外表现影响的临床数据。目前很少有病例报告专门描述维多珠单抗对坏疽性脓皮病的影响。我们报告了一名克罗恩病患者,自开始使用维多珠单抗以来,其腿部、腹部和面部的严重坏疽性脓皮病一直未发作。