Vedolizumab and new-onset spondyloarthritis: Debunking the myth.

United European Gastroenterol J

Department of Gastroenterology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.

Published: September 2024

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11497691PMC
http://dx.doi.org/10.1002/ueg2.12624DOI Listing

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Background And Aims: Vedolizumab is a humanized gut selective drug that targets α4β7 integrin and has been used successfully in the treatment of inflammatory bowel disease (IBD). Pivotal studies have already demonstrated the drug's safety, but some real-life cohorts have shown an increase in arthralgia and arthritis in patients using vedolizumab. These findings raised the question of whether these joint symptoms are extraintestinal manifestations of IBD (since the drug acts only in the gut) or if they are associated with the use of vedolizumab.

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Article Synopsis
  • - The study aimed to explore if starting vedolizumab (a medication for inflammatory bowel disease) was linked to new-onset spondyloarthritis (SpA) in patients with IBD through clinical evaluations and MRIs.
  • - 24 patients with active ulcerative colitis or Crohn's disease participated, with assessments made before starting treatment and at 8 and 24 weeks.
  • - Results showed that none of the patients developed new forms of axial or peripheral SpA after 24 weeks, indicating that vedolizumab does not appear to trigger these conditions in either TNF inhibitor-naïve or experienced patients.
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Article Synopsis
  • - The study investigates the effects of Vedolizumab (VDZ) on extraintestinal manifestations (EIMs) in patients with inflammatory bowel disease (IBD), focusing on the resolution of pre-existing EIMs during treatment.
  • - Out of 21 studies analyzed, 39% of VDZ-treated patients experienced resolution of their pre-existing EIMs, while rates of exacerbations and new onset EIMs were reported at 28% and 15%, respectively.
  • - VDZ is effective for certain skin and joint-related EIMs, particularly erythema nodosum and arthritis, although some patients may see an increase in EIMs during treatment.
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