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Vedolizumab Treatment in Extra-Intestinal Manifestations in Inflammatory Bowel Disease: A Systematic Review

Thomas Chateau, Stefanos Bonovas, Catherine Le Berre, Nicolas Mathieu, Silvio Danese, Laurent Peyrin-Biroulet
Journal of Crohn's & Colitis 2019 May 10

BACKGROUND AND AAIMS: We aimed to summarize the existing data on the effectiveness of vedolizumab in extra-intestinal manifestations (EIMs) in inflammatory bowel disease (IBD).

METHODS: We conducted a systematic literature search in PubMed and Cochrane Library, through October 2018. Interventional and non-interventional studies, as well as case-series studying vedolizumab and EIMs in adult patients with IBD, were considered eligible.

RESULTS: Three interventional studies (one randomized trial, n=1032; and two open-label trials, n=3247), five non-interventional studies (n=1496), and three case series (n=17) were included. Vedolizumab did not show any effectiveness in primary sclerosing cholangitis (PSC). While no effect was seen in pre-existing manifestations regarding arthralgia and arthritis, the occurrence of new rheumatic symptoms was lower among vedolizumab users compared to placebo; still higher, however, with vedolizumab than with tumor necrosis factor inhibitors. Finally, vedolizumab appears not efficacious for the treatment of cutaneous manifestations.

CONCLUSIONS: There is no strong evidence to suggest that vedolizumab may be efficacious for the treatment of pre-existing EIMs (especially PSC, rheumatic and cutaneous manifestations); however, it may reduce the occurrence of new EIMs.


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