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Ann Rheum Dis ; 76(5): 878-881, 2017 May.
Artículo en Inglés | MEDLINE | ID: mdl-27899374

RESUMEN

BACKGROUND: In inflammatory bowel disease (IBD), a new biological therapy has recently been approved. Vedolizumab is a humanised IgG1 monoclonal antibody to α4ß7 integrin that modulates gut lymphocyte trafficking. Although an exclusively local effect of vedolizumab could be expected based on the restricted presence of the α4ß7-mucosal vascular addressin cell adhesion molecule 1 complex in the gut, past combined success with anti-tumour necrosis factor, and previous demonstration of α4ß7 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 REPORT: A series of five patients with IBD who were treated with vedolizumab and promptly developed new onset or exacerbation of sacroiliitis or arthritis are reported. CONCLUSIONS: Vedolizumab 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.


Asunto(s)
Anticuerpos Monoclonales Humanizados/efectos adversos , Fármacos Gastrointestinales/efectos adversos , Sacroileítis/inducido químicamente , Espondilitis Anquilosante/inducido químicamente , Brote de los Síntomas , Adulto , Colitis Ulcerosa/tratamiento farmacológico , Enfermedad de Crohn/tratamiento farmacológico , Femenino , Humanos , Masculino , Persona de Mediana Edad
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