An induction or flare of arthritis and/or sacroiliitis by vedolizumab in inflammatory bowel disease: a case series

Annals of the Rheumatic Diseases - Tập 76 Số 5 - Trang 878-881 - 2017
Gaëlle Varkas1,2, Kristof Thevissen1,3, G. De Brabanter4, Liesbet Van Praet1, Frank Czul-Gurdian5, Heleen Cypers1,2, Joris De Kock1, Philippe Carron1,3, Martine De Vos6, Pieter Hindryckx6, Joris Arts7, Isabelle Vanneuville3, P Schoenaers8, Barbara Claerhout8, María T. Abreu5, Filip Van den Bosch1, Dirk Elewaut9
1Department of Rheumatology, Ghent University Hospital, Ghent, Belgium
2VIB Inflammation Research Center, Ghent University, Ghent, Belgium
3Department of Rheumatology/Physical medicine and rehabilitation, AZ Alma, Sijsele-Eeklo, Belgium
4Department of Rheumatology, AZ Sint-Lucas Brugge, Bruges, Belgium
5The Crohn's and Colitis Center, Miller School of Medicine, University of Miami, Miami, Florida, USA
6Department of Gastroenterology, Ghent University Hospital, Ghent, Belgium
7Department of Gastroenterology, AZ Sint-Lucas Brugge, Bruges, Belgium
8Department of Gastroenterology, AZ Alma, Sijsele-Eeklo, Belgium
9Department of Rheumatology, Ghent University Hospital, De Pintelaan 185, Ghent 9000, Belgium

Tóm tắt

BackgroundIn inflammatory bowel disease (IBD), a new biological therapy has recently been approved. Vedolizumab is a humanised IgG1 monoclonal antibody to α4β7 integrin that modulates gut lymphocyte trafficking. Although an exclusively local effect of vedolizumab could be expected based on the restricted presence of the α4β7–mucosal vascular addressin cell adhesion molecule 1 complex in the gut, past combined success with anti-tumour necrosis factor, and previous demonstration of α4β7 integrin in the joint, led to the expectation of a therapeutic efficacy in spondyloarthritis. Nonetheless, the effect of vedolizumab on extraintestinal manifestations—and especially the joint—has not been reported so far.Case reportA series of five patients with IBD who were treated with vedolizumab and promptly developed new onset or exacerbation of sacroiliitis or arthritis are reported.ConclusionsVedolizumab therapy does not seem to show any efficacy in and might even induce arthritis and/or sacroiliitis. However, larger cohort studies are needed to provide information on the prevalence, the evolution and underlying mechanism.

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Thông tin xuất bản

Annals of the Rheumatic Diseases

Tập 76 Số 5

878-881

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