Successful long-term treatment of paediatric ulcerative colitis with vedolizumab: a case report
Carla Codina-Jiménez1, Maite Bosch Peligero2,3, Cristina Rodríguez-Bernuz2
1Pharmacy Department, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain carla.codinaa@gmail.com.
Insights
Vedolizumab offers successful long-term treatment for severe paediatric ulcerative colitis (UC) unresponsive to infliximab. This case highlights vedolizumab
Area of Science:
- Gastroenterology and Hepatology
- Pediatric Gastroenterology
- Immunology
Background:
- Biologics are recommended for refractory pediatric ulcerative colitis (UC).
- Anti-tumor necrosis factor (Anti-TNF) inhibitors are first-line, with vedolizumab considered second-line.
- Limited data exists on long-term vedolizumab use in pediatric UC.
Observation:
- A 9-year-old boy with severe UC showed primary non-response to infliximab and steroid refractoriness.
- Vedolizumab therapy was initiated after negative infliximab drug and anti-drug antibody levels.
- The patient received a 6-week vedolizumab induction followed by monotherapy maintenance.
Findings:
- Vedolizumab achieved long-term clinical response and disease remission.
- The treatment demonstrated good tolerability in the pediatric patient.
- Negative drug and anti-drug antibody levels supported the switch to vedolizumab.
Implications:
- This case provides evidence for the long-term efficacy and safety of vedolizumab in pediatric UC.
- Vedolizumab may be a viable option for pediatric UC patients refractory to Anti-TNF therapy.
- Further research is warranted to support vedolizumab's use in pediatric UC
Abstract:
Biologics are recommended to treat paediatric ulcerative colitis (UC) that is chronically active or steroid-dependent despite aminosalicylic acids (5-ASA) and thiopurine treatments. Anti-tumour necrosis factor inhibitors (Anti-TNF inhibitors) are the agents of choice and vedolizumab could be considered as second-line biologic therapy.In the current case, we aim to describe a successful long-term treatment with vedolizumab in a 9-year-old boy with severe UC and primary non-response to infliximab. Concomitant azathioprine was used, and steroid refractoriness was also detected. Drug and anti-drug antibody levels were negative after infliximab induction so a switch to a 6-week-induction vedolizumab regimen followed by a maintenance regimen as a monotherapy was decided. The clinical response and tolerability to vedolizumab allowed long-term disease remission. Vedolizumab is currently non-authorised to treat paediatric patients and there is limited data on long-term treatments to date. This case contributes to the literature by adding evidence on the long-term efficacy and safety of vedolizumab in paediatric UC.
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