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Vedolizumab in Refractory Microscopic Colitis : An International Case Series

Riviere, Pauline (author)
Katholieke Univ Leuven, Belgium
Münch, Andreas, 1970- (author)
Linköpings universitet,Avdelningen för neuro- och inflammationsvetenskap,Medicinska fakulteten,Region Östergötland, Magtarmmedicinska kliniken
Michetti, Pierre (author)
Gastroenterol La Source Beaulieu, Switzerland
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Chande, Nilesh (author)
Western Univ, Canada
de Hertogh, Gert (author)
Katholieke Univ Leuven, Belgium
Schoeters, Patrick (author)
AZA Herentals, Belgium
Ferrante, Marc (author)
Katholieke Univ Leuven, Belgium
Vermeire, Severine (author)
Katholieke Univ Leuven, Belgium
Van Assche, Gert (author)
Katholieke Univ Leuven, Belgium
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 (creator_code:org_t)
2018-10-17
2019
English.
In: Journal of Crohn's & Colitis. - : Oxford University Press. - 1873-9946 .- 1876-4479. ; 13:3, s. 337-340
  • Journal article (peer-reviewed)
Abstract Subject headings
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  • Background Evidence for second-line therapy in patients with microscopic colitis [MC] failing budesonide is scarce, although anti-tumour necrosis factors [anti-TNFs], methotrexate and azathioprine have been reported to be effective in small cohort studies. Vedolizumab, a monoclonal antibody targeting 47-integrin, prevents homing of T-cells to the gut. We evaluated clinical remission with vedolizumab in budesonide-refractory MC patients. Methods We solicited gastroenterologists in Europe and Canada for cases of MC treated with vedolizumab. Vedolizumab 300 mg IV was administered at weeks 0, 2 and 6, and then every 8 weeks. Clinical remission and histological remission were defined as less than three stools per day and normalization of histology, respectively, after induction treatment. Results Eleven cases were retrieved (nine females, lymphocytic colitis [LC] n = 5, collagenous colitis [CC] n = 6). Median [interquartile range] disease duration at vedolizumab initiation was 51 [29-70] months. Nine of 11 patients had failed one immunosuppressant and ten of 11 at least one anti-TNF agent. After three infusions of vedolizumab, clinical remission was observed in 5/11 patients [two LC and three CC] of whom three remained well with maintenance therapy [median duration of 13 months]. Biopsies were obtained from 9/11 patients. Histological remission was observed in 3/4 patients with clinical remission [2/3 CC, 1/1 LC] and 0/5 patients without clinical improvement. Conclusion In a series of highly refractory MC patients, vedolizumab induced clinical remission in 5/11 subjects, of whom 75% showed normalized histology. Larger randomized trials are needed to assess the efficacy of vedolizumab in patients with MC.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Gastroenterologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Gastroenterology and Hepatology (hsv//eng)

Keyword

microscopic colitis; refractory; vedolizumab; treatment outcome

Publication and Content Type

ref (subject category)
art (subject category)

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