A pediatric case of moderate active ulcerative colitis successfully treated with vedolizumab in Japan

Ikeuchi, Aiko; Kakiuchi, Toshihiko; Ibi, Arisa; Matsuo, Muneaki

doi:10.1007/s12328-020-01260-y

Cited by 3 publications

(1 citation statement)

References 26 publications

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“…However, due to the failure of IFX, the anti-TNF-α agent, and due to the need for prolonged high-dose steroids even after IFX administration, ADA treatment was not expected to be effective. By taking these considerations into account and by revising the VARSITY study, a previous Japanese case report about the efficacy and safety of VDZ administration in pediatric ulcerative colitis (12), VDZ treatment was selected as the second-line treatment in our case.…”

Section: Discussionmentioning

confidence: 99%

A pediatric case of infliximab-resistant ulcerative colitis successfully treated using vedolizumab

et al. 2023

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Pediatric ulcerative colitis is likely to be more severe than adult ulcerative colitis. Failure to thrive should be considered during therapy. A 10-year-old boy was diagnosed with ulcerative colitis based on his clinical presentation and colonoscopy and biopsy results. The administration of 5-aminosalicylic acid and prednisolone resulted in remission ; however, the symptoms reappeared after the discontinuation of prednisolone. Then, infliximab was administered ; however, the patient was resistant to it and appeared to be dependent on prednisolone. Vedolizumab, a monoclonal antibody against α α4β β7 integrin, was administered, which resulted in rapid remission. A steady decrease in prednisolone followed, and remission was maintained even after prednisolone discontinuation. Vedolizumab may be effective in pediatric patients with moderate-to-severe refractory ulcerative colitis. Vedolizumab prevents lymphocytes from binding to MAdCAM-1, which is selectively expressed in the gastrointestinal submucosa, leading to the mitigation of the systemic side effects of immunosuppression, such as infections. In Japan, vedolizumab use is not yet approved for use in children, but its effectiveness and safety in children is expected to be investigated in the future.

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Section: Discussionmentioning

confidence: 99%