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Vedolizumab Treatment in Extra-Intestinal Manifestations in Inflammatory Bowel Disease: A Systematic Review
Thomas Chateau1, Stefanos Bonovas2,3, Catherine Le Berre4,5
1Department of Hepato-Gastroenterology, University Hospital of Grenoble, University of Grenoble Alpes, Grenoble, France.
Background And Aims:
We aimed to summarize 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 the Cochrane Library, up to 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 = 347], 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; occurrence was higher, however, with vedolizumab than with tumour necrosis factor inhibitors. Finally, vedolizumab appears not to be 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], although it may reduce the occurrence of new EIMs.
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