Year 2017 / Volume 109 / Number 9
Case Report
Efficacy and safety of vedolizumab as a treatment option for moderate to severe refractory ulcerative colitis in two patients after liver transplant due to primary sclerosing cholangitis

659-662

DOI: 10.17235/reed.2017.5024/2017

Raúl Vicente Olmedo Martín, Víctor Amo Trillo, Rocío González Grande, Miguel Jiménez Pérez,

Abstract
Vedolizumab is a humanized IgG1 monoclonal antibody that selectively blocks the lymphocyte integrin α4β7 and prevents its interaction with endothelial adhesion molecules and subsequent transmigration to the gastrointestinal tract. The drug was approved in 2014 for the induction and maintenance treatment of ulcerative colitis and moderate to severe Crohn’s disease that is refractory or intolerant to conventional treatment with corticoids and immunosuppressants and/or anti-TNFα drugs. However, inflammatory bowel disease has a variable behavior following liver transplant. One third of patients with ulcerative colitis associated with primary sclerosing cholangitis are expected to deteriorate despite receiving immunosuppression to prevent rejection. There is limited experience with anti-TNFα agents in patients with inflammatory bowel disease in the setting of liver transplantation and the studies to date involve a limited number of cases. The efficacy and safety data of vedolizumab in this situation are unreliable and very preliminary. We present two cases with the aim to present the efficacy and safety of vedolizumab after one year of treatment in two patients who underwent a transplant due to primary sclerosing cholangitis. One case had de novo post-transplant ulcerative colitis refractory to two anti-TNFα drugs (golimumab and infliximab). The other patient had a colostomy due to fulminant colitis and developed severe ulcerative proctitis refractory to infliximab after reconstruction with an ileorectal anastomosis.
Share Button
New comment
Comments
No comments for this article
References
1 Feagan BG, Rutgeerts P, Sands BE, et al. Velolizumab as induction and maintenance therapy for ulcerative colitis. N Engl J Med 2013, 22;369(8):699-710. DOI: 10.1056/NEJMoa1215734
2 Sandborn WJ, Feagan BG, Rutgeerts P, et al. Vedolizumab as induction and maintenance therapy for Crohn’s disease. N Engl J Med 2013; 369: 711–721. DOI: 10.1056/NEJMoa1215739
3 Rossi RE, Conte D, Massironi, S. Primary sclerosing cholangitis associated with inflammatory bowel disease: an update. Eur J Gastroenterol Hepatol 2016 Feb;28(2):123-13. DOI: 10.1097/MEG.0000000000000532.
4 Schnitzler F, Friedrich M, Stallhofer J, et al. Solid organ transplantation in patients with inflammatory bowel diseases (IBD): analysis of transplantation outcome and IBD activity in a large single center cohort. PLoS ONE 2015; 10: e0135807. DOI: 10.1371/journal.pone.0135807
5 Sandhu A, Alameel T, Dale CH, et al. The safety and efficacy of antitumour necrosis factor-alpha therapy for inflammatory bowel disease in patients post liver transplantation: a case series. Aliment Pharmacol Ther 2012; 36: 159–165 DOI:10.1111/j.1365-2036.2012.05141.x
6 Mohabbat AB, Sandborn WJ, Loftus EV, et al. Anti-tumour necrosis factor treatment of inflammatory bowel disease in liver transplant recipients. Aliment Pharmacol Ther 2012; 36: 569–74. DOI:10.1111/j.1365-2036.2012.05217.x
7 Meszaros M, Pageaux GP, Altwegg R. Management of ulcerative colitis using vedolizumab after liver transplantation for primary sclerosing cholangitis. J Crohns Colitis 2016; 10: 236. DOI:10.1093/ecco-jcc/jjv182
8 Muntaz S, Goh J, Hirschfield G, et al. Evolving strategies to reduce colectomy rates in primary sclerosing cholangitis-inflammatory bowel disease: clinical remission of corticosteroid refractory colitis post-liver transplant with vedolizumab. Frontline Gastroenterol doi:10.1136/flgastro-2016-100711
9 Lim TY, Pavlidis P, Gulati S, et al. Vedolizumab in inflammatory bowel disease associated with autoimmune liver disease pre- and postliver transplantation: a case series. Inflamm Bowel Dis 2016; 22: E39–40. DOI:10.1097/MIB.0000000000000906
10 Hartery K, O´Reilly S. Houlihan D, et al. Letter: Vedolizumab for the managment of inflammatory bowel disease in patients after liver trasplantation for primary sclerosing colangitis. Aliment Pharmacol Ther 2017;45:373-379 DOI:10.1111/apt.13861
Related articles

Letter

Abernethy syndrome as a cause of liver transplantation

DOI: 10.17235/reed.2024.10561/2024

Letter

Tofacitinib-induced eosinophilia

DOI: 10.17235/reed.2023.9831/2023

Letter

Perianal Paget’s disease

DOI: 10.17235/reed.2022.9304/2022

Letter

Chinese dragon sign of ulcerative colitis

DOI: 10.17235/reed.2022.9154/2022

Letter

Ulcerative colitis exacerbated by strongyloidiasis

DOI: 10.17235/reed.2022.9044/2022

Review

Clinical settings with tofacitinib in ulcerative colitis

DOI: 10.17235/reed.2022.8660/2022

Digestive Diseases Image

Posterior reversible encephalopathy syndrome (PRES) in post liver transplantation

DOI: 10.17235/reed.2022.8694/2022

Letter

Mesalazine induced interstitial pneumonitis in the COVID era

DOI: 10.17235/reed.2022.8635/2021

Letter

Ertapenem neurotoxicity in liver transplantation

DOI: 10.17235/reed.2021.8469/2021

Digestive Diseases Image

Ischemic cholangiopathy following hepatic artery pseudoaneurysm with thrombosis

DOI: 10.17235/reed.2021.8395/2021

Letter

EBVMCU in a liver-transplant patient

DOI: 10.17235/reed.2021.8064/2021

Digestive Diseases Image

Percutaneous treatment of a splenorenal shunt with an atrial septal closure device

DOI: 10.17235/reed.2020.7701/2020

Review

Physical frailty in liver transplantation

DOI: 10.17235/reed.2020.7448/2020

Letter

Management of hepatic artery aneurysms

DOI: 10.17235/reed.2020.7219/2020

Letter

The effect of Adacolumn® on ulcerative colitis with COVID-19

DOI: 10.17235/reed.2020.7156/2020

Digestive Diseases Image

Epithelioid hemangioendothelioma: a rare cause of a liver tumor

DOI: 10.17235/reed.2020.7127/2020

Letter

Sweet syndrome in severe ulcerative flare

DOI: 10.17235/reed.2020.6995/2020

Letter to the Editor

Post-transplant lymphoproliferative disease after liver transplantation

DOI: 10.17235/reed.2017.5387/2017

Letter to the Editor

Ulcerative colitis with gastric and duodenal involvement

DOI: 10.17235/reed.2017.4685/2016

Editorial

Specialist care in the management of inflammatory bowel disease

DOI: 10.17235/reed.2016.4628/2016

Original

Mercaptopurine and inflammatory bowel disease: the other thiopurine

DOI: 10.17235/reed.2016.4546/2016

Letter to the Editor

Liver metastasis from colorectal cancer 12 years after liver transplantation

DOI: 10.17235/reed.2017.4507/2016

Case Report

Mesalamine-induced myopericarditis - A case report

DOI: 10.17235/reed.2016.4016/2015

Citation tools
Olmedo Martín R, Amo Trillo V, González Grande R, Jiménez Pérez M. Efficacy and safety of vedolizumab as a treatment option for moderate to severe refractory ulcerative colitis in two patients after liver transplant due to primary sclerosing cholangitis . 5024/2017


Download to a citation manager

Download the citation for this article by clicking on one of the following citation managers:

Metrics
This article has received 1348 visits.
This article has been downloaded 430 times.

Statistics from Dimensions


Statistics from Plum Analytics

Publication history

Received: 21/04/2017

Accepted: 17/05/2017

Online First: 14/07/2017

Published: 31/08/2017

Article revision time: 18 days

Article Online First time: 84 days

Article editing time: 132 days


Share
This article has been rated by 3 readers.
Reader rating:
Valora este artículo:




Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
The Spanish Journal of Gastroenterology is the official organ of the Sociedad Española de Patología Digestiva, the Sociedad Española de Endoscopia Digestiva and the Asociación Española de Ecografía Digestiva
Cookie policy Privacy Policy Legal Notice © Copyright 2023 y Creative Commons. The Spanish Journal of Gastroenterology