title: [Vedolizumab in the treatment of Crohn's disease].
abstract: The anti-TNFα agents, infliximab and adalimumab, are effective in the treatment of Crohn's disease. Nevertheless, approximately one-third of patients do not initially respond to treatment and a substantial proportion experience loss of efficacy or intolerance to these drugs. Therefore, new drugs are obviously required, aimed at therapeutic targets other than TNFα. Notable among the therapeutic alternatives are drugs targeting integrins. Vedolizumab is a humanized monoclonal antibody that binds specifically to the α4β7 integrin, inhibiting T lymphocytes from binding to adhesion molecules (MAdCAM-1), which are expressed mainly in the small bowel and colon. Consequently, and unlike natalizumab, vedolizumab can be considered a specific intestinal immunosuppressant, making it especially attractive. The present article reviews the role of vedolizumab in Crohn's disease, paying special attention to its pharmacokinetic/pharmacodynamic properties, indications, effectiveness, and safety.
authors.affiliation: Servicio de Aparato Digestivo, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP) y Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, España. Electronic address: javier.p.gisbert@gmail.com.
authors.forename: Javier P
authors.initials: JP
authors.lastname: Gisbert
authors.affiliation: Servicio de Aparato Digestivo, Hospital Universitari Germans Trias i Pujol y CIBEREHD, Badalona, España.
authors.forename: Eugeni
authors.initials: E
authors.lastname: Domènech
mesh_terms: D000068879:Adalimumab / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized / Q000494:pharmacology* / Q000627:therapeutic use*; D015815:Cell Adhesion Molecules; D003424:Crohn Disease / Q000188:drug therapy*; D005765:Gastrointestinal Agents / Q000494:pharmacology* / Q000627:therapeutic use*; D006801:Humans; D007136:Immunoglobulins / Q000378:metabolism; D000069285:Infliximab / Q000627:therapeutic use; D016023:Integrins / Q000037:antagonists & inhibitors*; D009088:Mucoproteins / Q000378:metabolism; D013601:T-Lymphocytes / Q000276:immunology; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D015815:Cell Adhesion Molecules; D005765:Gastrointestinal Agents; D007136:Immunoglobulins; D016023:Integrins; C504265:MADCAM1 protein, human; D009088:Mucoproteins; C439524:TNF protein, human; D014409:Tumor Necrosis Factor-alpha; C071777:integrin alpha4beta7; C543529:vedolizumab; D000069285:Infliximab; D000068879:Adalimumab
keywords: Anti-TNF; Crohn's disease; Enfermedad de Crohn; Vedolizumab