PMID- 30329034 OWN - NLM STAT- MEDLINE DCOM- 20190819 LR - 20190819 IS - 1876-4479 (Electronic) IS - 1873-9946 (Linking) VI - 13 IP - 3 DP - 2019 Mar 26 TI - Vedolizumab in Refractory Microscopic Colitis: An International Case Series. PG - 337-340 LID - 10.1093/ecco-jcc/jjy169 [doi] AB - BACKGROUND: Evidence for second-line therapy in patients with microscopic colitis [MC] failing budesonide is scarce, although anti-tumour necrosis factors [anti-TNFs], methotrexate and azathioprine have been reported to be effective in small cohort studies. Vedolizumab, a monoclonal antibody targeting alpha4beta7-integrin, prevents homing of T-cells to the gut. We evaluated clinical remission with vedolizumab in budesonide-refractory MC patients. METHODS: We solicited gastroenterologists in Europe and Canada for cases of MC treated with vedolizumab. Vedolizumab 300 mg IV was administered at weeks 0, 2 and 6, and then every 8 weeks. Clinical remission and histological remission were defined as less than three stools per day and normalization of histology, respectively, after induction treatment. RESULTS: Eleven cases were retrieved (nine females, lymphocytic colitis [LC] n = 5, collagenous colitis [CC] n = 6). Median [interquartile range] disease duration at vedolizumab initiation was 51 [29-70] months. Nine of 11 patients had failed one immunosuppressant and ten of 11 at least one anti-TNF agent. After three infusions of vedolizumab, clinical remission was observed in 5/11 patients [two LC and three CC] of whom three remained well with maintenance therapy [median duration of 13 months]. Biopsies were obtained from 9/11 patients. Histological remission was observed in 3/4 patients with clinical remission [2/3 CC, 1/1 LC] and 0/5 patients without clinical improvement. CONCLUSION: In a series of highly refractory MC patients, vedolizumab induced clinical remission in 5/11 subjects, of whom 75% showed normalized histology. Larger randomized trials are needed to assess the efficacy of vedolizumab in patients with MC. CI - Copyright (c) 2018 European Crohn's and Colitis Organisation (ECCO). Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com. FAU - Riviere, Pauline AU - Riviere P AD - Department of Gastroenterology and Hepatology, University Hospitals Leuven, KU Leuven, Herestraat, Leuven, Belgium. FAU - Munch, Andreas AU - Munch A AD - Division of Gastroenterology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linkoping University, Linkoping, Sweden. FAU - Michetti, Pierre AU - Michetti P AD - Gastro-enterologie La Source-Beaulieu, Lausanne, Switzerland. FAU - Chande, Nilesh AU - Chande N AD - Division of Gastroenterology, Department of Medicine, Western University, London, Ontario, Canada. FAU - de Hertogh, Gert AU - de Hertogh G AD - Department of Pathology, University Hospitals Leuven, KU Leuven, Herestraat, Leuven, Belgium. FAU - Schoeters, Patrick AU - Schoeters P AD - Department of Gastroenterology, AZA Herentals, Herentals, Belgium. FAU - Ferrante, Marc AU - Ferrante M AD - Department of Gastroenterology and Hepatology, University Hospitals Leuven, KU Leuven, Herestraat, Leuven, Belgium. FAU - Vermeire, Severine AU - Vermeire S AD - Department of Gastroenterology and Hepatology, University Hospitals Leuven, KU Leuven, Herestraat, Leuven, Belgium. FAU - Van Assche, Gert AU - Van Assche G AD - Department of Gastroenterology and Hepatology, University Hospitals Leuven, KU Leuven, Herestraat, Leuven, Belgium. LA - eng PT - Journal Article PT - Multicenter Study PL - England TA - J Crohns Colitis JT - Journal of Crohn's & colitis JID - 101318676 RN - 0 (Anti-Inflammatory Agents) RN - 0 (Antibodies, Monoclonal, Humanized) RN - 0 (Gastrointestinal Agents) RN - 51333-22-3 (Budesonide) RN - 9RV78Q2002 (vedolizumab) MH - Anti-Inflammatory Agents/therapeutic use MH - Antibodies, Monoclonal, Humanized/*therapeutic use MH - Budesonide/therapeutic use MH - Canada MH - Colitis, Collagenous/*drug therapy/*pathology MH - Colitis, Lymphocytic/*drug therapy/*pathology MH - Europe MH - Female MH - Gastrointestinal Agents/*therapeutic use MH - Humans MH - Maintenance Chemotherapy MH - Male MH - Middle Aged MH - Remission Induction MH - Retreatment MH - Retrospective Studies OTO - NOTNLM OT - microscopic colitis OT - refractory OT - treatment outcome OT - vedolizumab EDAT- 2018/10/18 06:00 MHDA- 2019/08/20 06:00 CRDT- 2018/10/18 06:00 PHST- 2018/10/18 06:00 [pubmed] PHST- 2019/08/20 06:00 [medline] PHST- 2018/10/18 06:00 [entrez] AID - 5133624 [pii] AID - 10.1093/ecco-jcc/jjy169 [doi] PST - ppublish SO - J Crohns Colitis. 2019 Mar 26;13(3):337-340. doi: 10.1093/ecco-jcc/jjy169.