Vedolizumab
Mechanism :
Vedolizumab is a humanized monoclonal antibody that binds to the alpha4beta7 integrin and blocks the interaction of alpha4beta7 integrin with mucosal addressin cell adhesion molecule-1 (MAdCAM-1) and inhibits the migration of memory T-lymphocytes across the endothelium into inflamed gastrointestinal parenchymal tissue.
Indication :
- Crohn’s disease
- Ulcerative Colitis
Contraindications :
Serious or severe hypersensitivity to vedolizumab or any component of the formulation.
Dosing :
IV: Adults: 300 mg at 0, 2, and 6 weeks and then every 8 weeks thereafter. Discontinue therapy in patients who show no evidence of therapeutic benefit by week 14.
Prior to initiating treatment, all patients should be brought up to date with all immunizations according to current immunization guidelines.
Adverse Effect :
Headache, antibody development, arthralgia, nasopharyngitis, fatigue, nausea, skin rash, pruritus, increased serum AST & ALT, fever, infusion related reactions, progressive multifocal leukoencephalopathy.
Interaction :
Anti-TNF Agents: May enhance the adverse/toxic effect of Vedolizumab.
BCG (Intravesical): Immunosuppressants may diminish the therapeutic effect of BCG (Intravesical).
Natalizumab: Vedolizumab may enhance the adverse/toxic effect of Natalizumab.
Tacrolimus (Topical): May enhance the adverse/toxic effect of Immunosuppressants.
Vaccines (Live): Avoid use of live organism vaccines with immunosuppressants; live-attenuated vaccines should not be given for at least 3 months after immunosuppressants.
Hepatic Dose :
Dose adjustment may be required. If during therapy, signs of hepatic injury develop, stop therapy.