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vedolizumab (Entyvio)
Indications:
- inflammatory bowel disease (FDA-approved May 2014) [2]
- induction response is higher for ulcerative colitis than for Crohn's disease
- maintenance of remission in both is ~40% at 1 year [1]
Contraindications:
- hypersensitivity to vedolizumab or any of its components
- poor activity against inflammatory bowel-associated arthritis
- use TNF-alpha inhibitor (adalimumab) [5]
* Pregnancy:
- no reported birth defects, miscarriage or adverse maternal or fetal outcomes attributable to vedolizumab
- no fetal harm in animal studies [4]
Laboratory:
- vedolizumab in serum/plasma
- vedolizumab Ab in serum/plasma
Mechanism of action:
- monoclonal antibody to integrin alpha4/beta7
* reduces hospital admissions for inflammatory bowel disease [3]
* reduces frequency of flares & need for glucocorticoids [3]
Interactions
drug adverse effects of immunosuppressive agents
monitor with immunosuppressive agents
General
pharmaceutical monoclonal antibody
recombinant protein; chimer
immunosuppressive agent
References
- Feagan BG et al.
Vedolizumab as induction and maintenance therapy for ulcerative
colitis.
N Engl J Med 2013 Aug 22; 369:699
PMID: 23964933
http://www.nejm.org/doi/full/10.1056/NEJMoa1215734
- Sandborn WJ et al.
Vedolizumab as induction and maintenance therapy for Crohn's
disease.
N Engl J Med 2013 Aug 22; 369:711
PMID: 23964933
http://www.nejm.org/doi/full/10.1056/NEJMoa1215739
- FDA News Release. May 20, 2014
FDA approves Entyvio to treat ulcerative colitis and Crohn's
disease.
http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm398065.htm
- Walsh N
Vedolizumab Tx Cuts Admissions in IBD -
Rate of flares and need for corticosteroids also decreased.
MedPage Today. Dec 9, 2016
http://www.medpagetoday.com/MeetingCoverage/AIBD/61970
- Highlights of Prescribing Information
Entyvio (vedolizumab) for injection intravenous use
https://www.accessdata.fda.gov/drugsatfda_docs/label/2022/125476Orig1s046lbl.pdf
- NEJM Knowledge+ Complex Medical Care