Uncomplicated use of vedolizumab for inflammatory bowel disease in pregnancy: two case reports

Abstract

Background: Vedolizumab is an anti-α4β7 integrin that is indicated for use in moderate-to-severe ulcerative colitis and Crohn's disease. There is limited study into its safety and efficacy in pregnancy. We present two case reports, each with a successful pregnancy with vedolizumab-treated inflammatory bowel disease (IBD). Methods: Retrospective and observational study of two pregnant women with IBD who were treated with vedolizumab throughout pregnancy. Clinical information on both patients was collected from reading through electronically scanned patient notes and clinic letters. Information collected included: time and age of diagnosis, investigations, previous drug therapies tried, reasons for drug therapy failure, rationale for continuing vedolizumab throughout pregnancy, number of doses of vedolizumab received pre- and post-conception, disease severity throughout pregnancy, mode of delivery of baby and health of baby post-delivery. Information on the health of babies post-delivery and at time of writing was gathered by telephone conversation with both mothers. Results: In the two patients reported, vedolizumab use in the first and second trimester did not seem to negatively affect the outcome for both mother and baby. Both mothers had well-controlled IBD throughout pregnancy and delivered safely a healthy baby by elective caesarean section at term. At 8 and 4 months, both babies were noted to be healthy, with no congenital abnormality. Conclusions: In these two case reports, vedolizumab was safe and effective in both patient and baby. However, the use of vedolizumab in pregnancy requires further study.