title: Selective biologics for ulcerative colitis and Crohn's disease - clinical utility of vedolizumab.
abstract: Inflammatory bowel disease (IBD) encompasses a cluster of different disease phenotypes which are broadly classified into ulcerative colitis and Crohn's disease. Disease pathogenesis is driven by abnormal host immune responses to their resident gut microbiome in genetically susceptible individuals. Clinical disease features and outcomes are heterogenous and not unexpected as over 163 genetic loci are associated with disease susceptibility, and there are great variability in environmental exposures. Despite this variability, there has been relatively few efficacious therapies for particularly moderate-to-severe IBD. Treatment has been dominated by antitumor necrosis alpha agents with significant success but equally potentially serious adverse events. Therapeutic targeting of leucocyte trafficking has emerged as a viable alternative therapy, with vedolizumab being the lead compound. This review focuses primarily on its biological function as a selective gut immunotherapy, its safety and efficacy, and its emerging role as a mainstream therapy in managing IBD.
authors.affiliation: Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
authors.forename: Jill Mv
authors.initials: JM
authors.lastname: Petkau
authors.affiliation: Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
authors.forename: Bertus
authors.initials: B
authors.lastname: Eksteen
keywords: adhesion molecule antagonist; anti-α4β7 integrin; inflammatory bowel disease; leukocyte trafficking; monoclonal antibody; selective gut immunotherapy; tumor necrosis factor alpha