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Expert Consensus Paper on the use of Vedolizumab for the Management of Patients with Moderate-to-Severe Inflammatory Bowel Disease

Digestive and Liver Disease, In Press, Accepted Manuscript, Available online 7 January 2016, Available online 7 January 2016

Abstract

Crohn's Disease (CD) and Ulcerative Colitis (UC) are chronic, relapsing conditions resulting from uncontrolled inflammation of the intestinal mucosa. Both conditions are associated with significant disability and patients with CD face higher mortality rates compared to the general population. The increasing understanding of the immunological basis of the disease led to the introduction of biologic therapies targeting key pathways of the natural and adaptive immune response such as Tumor Necrosis Factor α (TNF-α) inhibitors and, more recently, integrin-receptor antagonists. Treatment with TNF-α inhibitors improved clinical and patient-reported outcomes for many patients who did not benefit from conventional therapy. However, a sizeable share of patients still face suboptimal outcomes due to primary or secondary therapy failure. With the introduction of VDZ, a biologic treatment targeting novel IBD-relevant biologic pathways, it is crucial to understand how to integrate such innovations into current clinical practice. To this end, a panel of 14 Italian experts in the management of IBD met for a roundtable discussion. Recommendations concerning the management of moderate-to-severe IBD based on experts’ opinions and literature review are discussed in the present report.

Keywords: Inflammatory Bowel Disease, Vedolizumab, Ulcerative Colitis, Crohn's Disease..

Footnotes

a Department of Internal Medicine and Geriatrics, Università Cattolica del Sacro Cuore, Rome, Italy

b DIMEC, University of Bologna, Bologna, Italy

c SC Gastroenterologia, AO Ordine Mauriziano, Turin, Italy

d IBD Center, Humanitas Research Hospital, Rozzano, Milan, Italy

e Biomedical Department of Internal and Specialist Medicine (DIBIMIS), Division of Medicine, Villa Sofia-V. Cervello Hospital, Palermo University, Palermo, Italy

f Unit of Gastroenterology, Azienda Ospedaliera San Camillo-Forlanini, Rome, Italy

g Dipartimento di Scienze Biomediche per la Salute, Università di Milano, Milan, Italy

Corresponding author. DIMEC, University of Bologna, Bologna, Via Massarenti 9, Bologna, Italy.