Pharmacy Department, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
Pharmacy Department, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain.
Eur J Hosp Pharm. 2023 Nov;30(6):e30. doi: 10.1136/ejhpharm-2022-003434. Epub 2022 Dec 9.
Biologics are recommended to treat paediatric ulcerative colitis (UC) that is chronically active or steroid-dependent despite aminosalicylic acids (5-ASA) and thiopurine treatments. Anti-tumour necrosis factor inhibitors (Anti-TNF inhibitors) are the agents of choice and vedolizumab could be considered as second-line biologic therapy.In the current case, we aim to describe a successful long-term treatment with vedolizumab in a 9-year-old boy with severe UC and primary non-response to infliximab. Concomitant azathioprine was used, and steroid refractoriness was also detected. Drug and anti-drug antibody levels were negative after infliximab induction so a switch to a 6-week-induction vedolizumab regimen followed by a maintenance regimen as a monotherapy was decided. The clinical response and tolerability to vedolizumab allowed long-term disease remission. Vedolizumab is currently non-authorised to treat paediatric patients and there is limited data on long-term treatments to date. This case contributes to the literature by adding evidence on the long-term efficacy and safety of vedolizumab in paediatric UC.
生物制剂被推荐用于治疗氨基水杨酸（5-ASA）和巯嘌呤治疗后仍处于慢性活动期或类固醇依赖的小儿溃疡性结肠炎（UC）。抗肿瘤坏死因子抑制剂（Anti-TNF 抑制剂）是首选药物，而维多珠单抗可被视为二线生物治疗药物。在本病例中，我们旨在描述一名 9 岁男孩严重 UC 对英夫利昔单抗原发性无反应后使用维多珠单抗进行成功的长期治疗。同时使用了硫唑嘌呤，也检测到了类固醇耐药性。英夫利昔单抗诱导后药物和抗药物抗体水平均为阴性，因此决定改用维多珠单抗 6 周诱导方案，然后进行单药维持治疗。对维多珠单抗的临床反应和耐受性允许长期疾病缓解。维多珠单抗目前尚未获准用于治疗儿科患者，迄今为止，关于长期治疗的数据有限。该病例通过提供关于维多珠单抗在小儿 UC 中的长期疗效和安全性的证据，为文献做出了贡献。
