Vedolizumab: toward a personalized therapy paradigm for people with ulcerative colitis.
Vedolizumab: toward a personalized therapy paradigm for people with ulcerative colitis.
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DOI：
10.2147/ceg.s110547
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发表时间：
2017
影响因子：
2.4
通讯作者：
Irving PM
中科院分区：
文献类型：
--
作者：
Dart RJ;Samaan MA;Powell N;Irving PM
溃疡性结肠炎（UC）是一种慢性复发和缓解性炎症性肠病，具有特征性的粘膜白细胞浸润。免疫抑制包括抗tnf -α治疗是许多人的主要治疗方法；然而，全身免疫抑制并不是普遍有效的，并且与潜在的副作用有关。嗜肠整合素α4β7在白细胞上表达，介导从循环向肠黏膜的迁移。Vedolizumab是一种单克隆抗体，通过α4 - β7阻断白细胞的分泌，防止白细胞在粘膜中积聚，在不抑制全身免疫的情况下减轻炎症。Vedolizumab已在一项III期试验中用于UC的评估，证明了其作为诱导和维持药物的有效性。在本文中，我们回顾了临床试验数据，并探索了越来越多的“现实世界”有效性数据，调查了临床实践中vedolizumab的反应率和缓解率。此外，我们回顾了越来越多的数据支持与vedolizumab相关的可靠安全性。
Ulcerative colitis (UC) is a chronic relapsing and remitting inflammatory bowel disease, with a characteristic leukocytic infiltration of the mucosa. Immunosuppression including anti-TNF-α therapy is a mainstay of treatment for many; however, systemic immunosuppression is not universally effective and is associated with potential side effects. The gut-tropic integrin α4β7, which is expressed on leukocytes, mediates migration from the circulation to the intestinal mucosa. Vedolizumab is a monoclonal antibody which blocks the egress of leukocytes via α4β7, preventing accumulation in the mucosa, and attenuating inflammation without systemic immunosuppression. Vedolizumab has been evaluated in UC in a phase III trial, demonstrating efficacy as both an induction and a maintenance agent. In this article, we review the clinical trial data and also explore the growing body of “real-world” effectiveness data, investigating response and remission rates of vedolizumab in clinical practice. In addition, we review the increasing volume of data supporting the reassuring safety profile associated with vedolizumab.