title: Vedolizumab is an effective alternative in inflammatory bowel disease patients with anti-TNF-alpha therapy-induced dermatological side effects.
abstract: BACKGROUND
  The treatment of patients with inflammatory bowel diseases has been revolutionized by the introduction of biological therapy with TNF-alpha blockers. However, TNF-alpha blockers are also associated with a wide variety of dermatological side effects, such as local skin infections, psoriasis and eczema. A new biological therapy, targeting the gut-specific adhesion molecule alpha4beta7 integrin, is the humanized monoclonal IgG1 antibody vedolizumab. Vedolizumab prevents leukocyte migration to the gastrointestinal tract, thereby reducing inflammation. This gut-specific therapy has the potential to reduce systemic side effects, including dermatological ones.
  
  
  METHODS
  We describe 3 inflammatory bowel disease patients who experience anti-TNF-alpha therapy-induced dermatological side effects, consisting of hidradenitis suppurativa, a folliculitis, scalp psoriasis and a dissecting folliculitis.
  
  
  RESULTS
  In all patients, anti-TNF-alpha therapy-induced dermatological side effects diminished after switching to vedolizumab.
  
  
  CONCLUSIONS
  Vedolizumab may be a viable alternative biological therapy in inflammatory bowel disease patients who experience anti-TNF-alpha therapy-induced dermatological side effects.
authors.affiliation: Department of Gastroenterology and Hepatology, Catharina Hospital Eindhoven, Eindhoven, The Netherlands. Electronic address: philippe.pijls@catharinaziekenhuis.nl.
authors.forename: Philippe A R R
authors.initials: PA
authors.lastname: Pijls
authors.affiliation: Department of Gastroenterology and Hepatology, Catharina Hospital Eindhoven, Eindhoven, The Netherlands. Electronic address: lennard.gilissen@catharinaziekenhuis.nl.
authors.forename: Lennard P L
authors.initials: LP
authors.lastname: Gilissen
mesh_terms: D000068879:Adalimumab / Q000009:adverse effects; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D001691:Biological Therapy; D005260:Female; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000628:therapy*; D000069285:Infliximab / Q000009:adverse effects; D016023:Integrins / Q000037:antagonists & inhibitors; D008297:Male; D008875:Middle Aged; D012871:Skin Diseases / Q000139:chemically induced*; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors; D055815:Young Adult
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D005765:Gastrointestinal Agents; D016023:Integrins; D014409:Tumor Necrosis Factor-alpha; C071777:integrin alpha4beta7; C543529:vedolizumab; D000069285:Infliximab; D000068879:Adalimumab
keywords: Inflammatory bowel diseases; Skin diseases; Vedolizumab