Efficacy and safety of vedolizumab as a treatment option for moderate to severe refractory ulcerative colitis in two patients after liver transplant due to primary sclerosing cholangitis
| Autor: | Miguel Jiménez Pérez, Víctor Amo Trillo, Raúl Vicente Olmedo Martín, Rocío González Grande |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
medicine.medical_specialty medicine.medical_treatment Cholangitis Sclerosing Liver transplantation Antibodies Monoclonal Humanized Inflammatory bowel disease Gastroenterology Vedolizumab Primary sclerosing cholangitis 03 medical and health sciences 0302 clinical medicine Gastrointestinal Agents Internal medicine Medicine Humans 030212 general & internal medicine Colitis lcsh:RC799-869 Liver transplant Gastrointestinal agent business.industry General Medicine medicine.disease Ulcerative colitis Infliximab Liver Transplantation Treatment Outcome 030211 gastroenterology & hepatology lcsh:Diseases of the digestive system. Gastroenterology Colitis Ulcerative Female business medicine.drug |
| Zdroj: | Revista Espanola de Enfermedades Digestivas, Vol 109, Iss 9, Pp 659-662 Revista Española de Enfermedades Digestivas v.109 n.9 2017 SciELO España. Revistas Científicas Españolas de Ciencias de la Salud instname |
| ISSN: | 1130-0108 |
| Popis: | Vedolizumab is a humanized IgG1 monoclonal antibody that selectively blocks the lymphocyte integrin α4β7 and prevents its interaction with endothelial adhesion molecules and subsequent transmigration to the gastrointestinal tract. The drug was approved in 2014 for the induction and maintenance treatment of ulcerative colitis and moderate to severe Crohn's disease that is refractory or intolerant to conventional treatment with corticoids and immunosuppressants and/or anti-TNFα drugs. However, inflammatory bowel disease has a variable behavior following liver transplant. One third of patients with ulcerative colitis associated with primary sclerosing cholangitis are expected to deteriorate despite receiving immunosuppression to prevent rejection. There is limited experience with anti-TNFα agents in patients with inflammatory bowel disease in the setting of liver transplantation and the studies to date involve a limited number of cases. The efficacy and safety data of vedolizumab in this situation are unreliable and very preliminary. We present two cases with the aim to present the efficacy and safety of vedolizumab after one year of treatment in two patients who underwent a transplant due to primary sclerosing cholangitis. One case had de novo post-transplant ulcerative colitis refractory to two anti-TNFα drugs (golimumab and infliximab). The other patient had a colostomy due to fulminant colitis and developed severe ulcerative proctitis refractory to infliximab after reconstruction with an ileorectal anastomosis. |
| Databáze: | OpenAIRE |
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