Tuesday, 18 Dec 2018

You are here

Vedolizumab Implicated in Exacerbations of SpA in IBD Patients

Beloved by gastroenterologist for treatment of inflammatory bowel disease (IBD), α4β7 integrin receptor vedolizumab (VDZ) has probably caught attention of many rheumatologist since the time it entered the market; largely for what it won't do for inflammatory arthritis.

Many rheumatologists have faced the problem of worsening Spondyloarthritis (SpA) symptoms while CD or UC was well controlled with the biologic in question. This was addressed in a abstract session today.

This was a single-center retrospective and observational study results were presented at this year's EULAR meeting to assess the effects of vedolizumab on joint manifestations in patients with IBD associated SpA.

A total of 171 TNFi experienced patients with IBD (60.8% Crohn's disease (CD) and 39.2 % Ulcerative colitis (UC)) who were treated with VDZ between 2014 and 2017 were observed for average 14 months in the study.  

Active IBD related SpA at the time of VDZ initiation was seen in 2.4% of the patients and 5.8% of the patients had their articular disease in remission.

As a result of VDZ treatment, no clinical benefit to the patients with active disease was observed. In addition VDZ was associated with acute exacerbation of SpA in 6 out of 10 patients who were previously in remission. one case of new onset SpA was reported.

Study concluded that in addition to not being beneficial in IBD-associated SpA, the medication may also be implicated in SpA exacerbations and trigger new onset IBD-associated SpA.

Disclosures: 
The author has no conflicts of interest to disclose related to this subject

Add new comment

More Like This

Kallikrein Inhibitor Lanadelumab Prevents Hereditary Angioedema Attacks

Hereditary angioedema is a rare autosomal dominant disorder due to C1 inhibitor deficiency (type I) or dysfunction (type II) that leads to dysregulated plasma kallikrein activity, excess bradykinin production, and unpredictable potentially life-threatening recurrent angioedema attacks.

FDA Approves Biosimilar Rituximab for NHL, not RA

The U.S. Food and Drug Administration on Wednesday approved Celltrion biosimilar of rituximab called Truxima; previously called CT-P10, now generically labeled as rituximab-abbs. This is the first biosimilar to the Rituxan currently approved to treat non-Hodgkin’s lymphoma. Truxima is not approved for use in rheumatoid arthritis, vasculitis, pemphigus vulgaris or chronic lymphocytic leukemia.

First FDA Approved Drug for HLH

The first drug specifically for primary hemophagocytic lymphohistiocytosis (HLH) was approved today, the FDA announced.

Emapalumab (Gamifant), manufactured by Novimmune SA, may be used in all patients (including newborns and older children) "who have refractory, recurrent, or progressive disease or intolerance with conventional HLH therapy," the FDA said.

Should Immunoglobulins be Monitored with Rituximab Use?

Boston researchers have found that in a large cohort study of patients receiving rituximab (RTX), most were not being monitored for hypogammaglobulinemia, despite the observed significant increase in severe infections and increased mortality in RTX treated patients.

IL-6 for Adult Still's: A New Option?

Some clinical benefits were seen among patients with adult-onset Still's disease treated with tocilizumab (Actemra) in a small clinical trial, but the study's primary endpoint was not met, Japanese researchers reported.