vedolizumabs

Vedolizumab is a humanized monoclonal antibody used to treat inflammatory bowel disease, specifically moderate to severely active ulcerative colitis and Crohn’s disease in adults and certain pediatric patients. It is marketed under the brand name Entyvio and is designed to be gut-selective, aiming to reduce intestinal inflammation with less systemic immunosuppression than some other therapies.

Mechanism of action

Vedolizumab targets the α4β7 integrin on memory T-lymphocytes, blocking its interaction with MAdCAM-1, a molecule expressed on gut-directed blood vessels. This prevents lymphocytes from trafficking to the gut mucosa, thereby decreasing inflammatory activity localized to the gastrointestinal tract.

Medical uses

Vedolizumab is indicated for adults with moderate to severely active ulcerative colitis or Crohn’s disease who have had an inadequate response, loss of response, or intolerance to conventional therapy or TNF inhibitors. It is also approved for selected pediatric patients in some regions, with dosing and eligibility based on local guidelines and regulatory approvals.

Administration and dosing

The treatment is given by intravenous infusion. A common regimen is 300 mg at weeks 0, 2, and 6, followed by every-8-weeks maintenance infusions. Infusion times are typically around 30 minutes. Dose adjustments and management of infusion reactions follow clinician judgment and regulatory labeling.

Safety and adverse effects

Vedolizumab is generally well tolerated. Common adverse events include headache, nasopharyngitis, and arthralgia. Infusion-related reactions and an increased risk of infections can occur. TB screening and consideration of vaccination status are recommended prior to initiation. It has a favorable safety profile relative to systemic immunosuppressants, and information on use in pregnancy should be discussed with a healthcare provider due to limited human data.

See also

Other anti-integrin therapies for IBD include natalizumab, though it has a different safety and efficacy profile due to its broader targeting.