title: Expert consensus paper on the use of Vedolizumab for the management of patients with moderate-to-severe Inflammatory Bowel Disease.
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.
authors.affiliation: IBD Unit, Complesso Integrato Columbus, Fondazione Policlinico Gemelli, Università Cattolica, Rome, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Armuzzi
authors.affiliation: DIMEC, University of Bologna, Bologna, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Gionchetti
authors.affiliation: SC Gastroenterologia, AO Ordine Mauriziano, Turin, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Daperno
authors.affiliation: IBD Center, Humanitas Research Hospital, Rozzano, Milan, Italy.
authors.forename: Silvio
authors.initials: S
authors.lastname: Danese
authors.affiliation: Biomedical Department of Internal and Specialist Medicine (DIBIMIS), Division of Medicine, Villa Sofia-V. Cervello Hospital, Palermo University, Palermo, Italy.
authors.forename: Ambrogio
authors.initials: A
authors.lastname: Orlando
authors.affiliation: Unit of Gastroenterology, Azienda Ospedaliera San Camillo-Forlanini, Rome, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Lia Scribano
authors.affiliation: Dipartimento di Scienze Biomediche per la Salute, Università di Milano, Milan, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Vecchi
authors.affiliation: DIMEC, University of Bologna, Bologna, Italy. Electronic address: fernando.rizzello@unibo.it.
authors.forename: Fernando
authors.initials: F
authors.lastname: Rizzello
mesh_terms: D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects / Q000627:therapeutic use*; D001691:Biological Therapy / Q000009:adverse effects / Q000379:methods*; D019468:Disease Management; D005765:Gastrointestinal Agents / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000145:classification / Q000188:drug therapy*; D017410:Practice Guidelines as Topic; D016032:Randomized Controlled Trials as Topic; D012720:Severity of Illness Index; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D005765:Gastrointestinal Agents; D014409:Tumor Necrosis Factor-alpha; C543529:vedolizumab
keywords: Crohn's Disease; Inflammatory Bowel Disease; Ulcerative Colitis; Vedolizumab