Vedolizumab in the treatment of Crohn's disease

The anti-INF alpha agents, intliximab and adalimumab, are effective in the treatment of Crohn's disease. Nevertheless, approximately one-third of patients do not initially respond to treatment and a substantial proportion experience loss of efficacy or intolerance to these drugs. Therefore, new drugs are obviously required, aimed at therapeutic targets other than TNF alpha. Notable among the therapeutic alternatives are drugs targeting integrins. Vedolizumab is a humanized monoclonal antibody that binds specifically to the alpha 4 beta 7 integrin, inhibiting T lymphocytes from binding to adhesion molecules (MAdCAM-1), which are expressed mainly in the small bowel and colon. Consequently, and unlike natalizumab, vedolizumab can be considered a specific intestinal immunosuppressant, making it especially attractive. The present article reviews the role of vedolizumab in Crohn's disease, paying special attention to its pharmacokinetic/pharmacodynamic properties, indications, effectiveness, and safety. (C) 2014 Elsevier Espana, S.L.U. and AEEH y AEG. All rights reserved.