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Gonzalez Diaz I, Gutierrez Riart M, Martin-Arranz MD, Plasencia Rodriguez C, Suarez Ferrer C. Incidence and Course of Joint Inflammation Associated with Inflammatory Bowel Disease in Patients Undergoing Treatment with Vedolizumab/Ustekinumab: The VEDUSTAR Study. J Clin Med 2024; 13:1076. [PMID: 38398390 PMCID: PMC10889195 DOI: 10.3390/jcm13041076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 02/10/2024] [Accepted: 02/11/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND The role of ustekinumab (UST) and vedolizumab (VDZ) in the extraintestinal joint manifestations of inflammatory bowel disease (IBD) remain unclear, and most existing studies are retrospective. The aim of this prospective study was to analyze the incidence of new-onset joint disease or the worsening of pre-existing IBD-associated joint disease in patients treated with UST and VDZ. METHODS The study population comprised IBD patients with previous spondyloarthritis (SpA) or new-onset arthropathy undergoing treatment with VDZ or UST. RESULTS Eighty patients were referred to rheumatology because of previous SpA or onset of symptoms. Most patients (90%) were anti-TNF experienced. Two patients with previous SpA (2/22; 9%) experienced a flare-up (one with UST and one with VDZ), and two patients with VDZ developed SpA during follow-up (2/58; 3%). Only one of these four patients did not have gastrointestinal symptoms, and VDZ was discontinued because of joint symptoms. The other three patients had concomitant intestinal activity, and treatment was not discontinued. CONCLUSION Our experience shows that treatment with UST and VDZ did not worsen joint disease in patients with SpA. Most remained stable or improved. In addition, poor control of IBD in patients with joint flare-ups could be the main cause of worsening SpA.
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Affiliation(s)
- Irene Gonzalez Diaz
- Gastroenterology Department, La Paz University Hospital, 28046 Madrid, Spain;
| | - Mariana Gutierrez Riart
- Rheumatology Department, La Paz University Hospital, 28046 Madrid, Spain; (M.G.R.); (C.P.R.)
| | - Maria Dolores Martin-Arranz
- Gastroenterology Department, La Paz University Hospital, 28046 Madrid, Spain;
- Hospital La Paz Institute for Health Research, La Paz University Hospital, 28046 Madrid, Spain
- Faculty of Medicine, Universidad Autónoma, 28046 Madrid, Spain
| | | | - Cristina Suarez Ferrer
- Gastroenterology Department, La Paz University Hospital, 28046 Madrid, Spain;
- Hospital La Paz Institute for Health Research, La Paz University Hospital, 28046 Madrid, Spain
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2
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Prevalence and predictors of arthralgia after initiation of vedolizumab in patients with inflammatory bowel disease: a retrospective cohort study. Eur J Gastroenterol Hepatol 2023; 35:371-375. [PMID: 36827531 DOI: 10.1097/meg.0000000000002527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
OBJECTIVES Vedolizumab is a mAb used for the treatment of moderate to severe ulcerative colitis and Crohn's disease. There is evidence that administration of vedolizumab has been associated with either new onset or reactivation of extra-intestinal manifestations, among which arthralgia is the most prominent. We aimed to study the incidence, characteristics and predictors for the occurrence of arthralgias in patients with inflammatory bowel disease (IBD) who receive vedolizumab. METHODS A retrospective cohort study was implemented in patients with IBD. The occurrence of new-onset and recurrent arthralgias were recorded. Multivariate Cox proportional-hazards models were used to identify factors associated with the endpoints of interest. RESULTS A total of 115 vedolizumab-treated IBD patients (male = 50.4%; ulcerative colitis = 70.4%; median follow-up = 12.7 months) participated. New-onset arthralgia occurred in 20.9%, and recurrent in 46.7% (45 patients at risk). Among patients with ulcerative colitis, multivariate Cox's proportional-hazards models showed, that new onset arthralgia was significantly associated with extensive colitis (hazard ratio = 2.91; 95% confidence interval, 1.04-8.12). Of 15 patients with concomitant treatment of azathioprine, no one manifested new-onset arthralgia (X2P = 0.03; Fisher's exact test P = 0.038). No predictors were identified for recurrent arthralgia. CONCLUSION Arthralgias is a common manifestation of vedolizumab treatment. Patients with extensive ulcerative colitis demonstrate a higher risk for new-onset arthralgia, whereas, concomitant treatment with azathioprine appears to be protective. These associations may be mediated by re-directed lymphocyte trafficking and may support concomitant immunomodulator administration in specific patient subpopulations who commence treatment with vedolizumab.
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3
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De Galan C, Truyens M, Peeters H, Mesonero Gismero F, Elorza A, Torres P, Vandermeulen L, Amezaga AJ, Ferreiro-Iglesias R, Holvoet T, Zabana Y, Reverter LP, Gonzales GB, Geldof J, Varkas G, De Vos M, Lobatón T. The Impact of Vedolizumab and Ustekinumab on Articular Extra-Intestinal Manifestations in Inflammatory Bowel Disease Patients: A Real-Life Multicentre Cohort Study. J Crohns Colitis 2022; 16:1676-1686. [PMID: 35442433 DOI: 10.1093/ecco-jcc/jjac058] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND AND AIMS Extra-intestinal manifestations are frequently reported in inflammatory bowel diseases. However, data comparing the effect of vedolizumab and ustekinumab on articular extra-intestinal manifestations are limited. The aim here was to evaluate differences in new-onset and the evolution of pre-existing joint extra-intestinal manifestations during both treatments. METHODS An international multicentre retrospective study was performed on inflammatory bowel disease patients who started vedolizumab or ustekinumab between May 2010 and December 2020. Extra-intestinal manifestations were assessed at baseline and joint extra-intestinal manifestations were evaluated throughout the 2-year follow-up. Arthropathy was defined by joint inflammation [arthritis/sacroiliitis], diagnosed by a rheumatologist, and arthralgia as articular pain without confirmed inflammation. Additionally, skin, ocular and hepatic extra-intestinal manifestations were assessed at baseline. Uni- and multivariate analyses were performed. RESULTS In total, 911 patients [vedolizumab: 584; ustekinumab: 327] were included. Deterioration of pre-existing arthropathy and rate of new-onset arthropathy were not significantly associated with vedolizumab over ustekinumab. Arthropathy was used as reason to stop treatment in six vedolizumab and two ustekinumab patients. The odds of developing new arthralgia within 6 months was higher in patients who took vedolizumab compared to ustekinumab (adjusted odds ratio [aOR]: 2.28 [1.01-5.15], p = 0.047). However, this effect was not sustained during the 2-year follow-up (aOR: 1.35 [0.80-2.29], p = 0.259). Deterioration of pre-existing arthralgia was comparable between ustekinumab and vedolizumab-treated patients. In two vedolizumab-treated patients arthralgia was given as the reason to stop treatment. CONCLUSIONS Vedolizumab and ustekinumab can be used safely in patients with articular extra-intestinal manifestations. Only a temporary increased risk for developing arthralgia has been observed under vedolizumab.
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Affiliation(s)
- Cara De Galan
- Department of Internal Medicine and Paediatrics, Ghent University, Ghent, Belgium.,VIB Center for Inflammation Research (IRC), Ghent University, Ghent, Belgium.,Ghent Gut Inflammation Group (GGIG), Ghent University, Ghent, Belgium
| | - Marie Truyens
- Department of Internal Medicine and Paediatrics, Ghent University, Ghent, Belgium.,VIB Center for Inflammation Research (IRC), Ghent University, Ghent, Belgium.,Ghent Gut Inflammation Group (GGIG), Ghent University, Ghent, Belgium.,Department of Gastroenterology, University Hospital Ghent, Ghent, Belgium
| | - Harald Peeters
- Department of Gastroenterology, AZ Sint Lucas, Ghent, Belgium
| | | | - Ainara Elorza
- Department of Gastroenterology, Hospital de Galdakao, Bilbao, Spain
| | - Paola Torres
- Department of Gastroenterology, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain
| | - Liv Vandermeulen
- Department of Gastroenterology, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel, Brussels, Belgium
| | | | - Rocio Ferreiro-Iglesias
- Department of Gastroenterology, Hospital Clínico Universitario de Santiago, Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Tom Holvoet
- Department of Gastroenterology, University Hospital Ghent, Ghent, Belgium.,Department of Gastroenterology, AZ Nikolaas, Sint-Niklaas, Belgium
| | - Yamile Zabana
- Department of Gastroenterology, Hospital Universitari Mútua de Terrassa, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, CIBERehd, Barcelona, Spain
| | - Laia Peries Reverter
- Department of Gastroenterology, Hospital Universitari de Girona Doctor Joseph Trueta, Girona, Spain
| | - Gerard Bryan Gonzales
- Department of Internal Medicine and Paediatrics, Ghent University, Ghent, Belgium.,VIB Center for Inflammation Research (IRC), Ghent University, Ghent, Belgium.,Nutrition, Metabolism and Genomics Group, Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands
| | - Jeroen Geldof
- Department of Internal Medicine and Paediatrics, Ghent University, Ghent, Belgium.,Department of Gastroenterology, University Hospital Ghent, Ghent, Belgium
| | - Gaëlle Varkas
- VIB Center for Inflammation Research (IRC), Ghent University, Ghent, Belgium.,Department of Rheumatology, University Hospital Ghent, Ghent, Belgium
| | - Martine De Vos
- Department of Internal Medicine and Paediatrics, Ghent University, Ghent, Belgium.,Ghent Gut Inflammation Group (GGIG), Ghent University, Ghent, Belgium
| | - Triana Lobatón
- Department of Internal Medicine and Paediatrics, Ghent University, Ghent, Belgium.,Department of Gastroenterology, University Hospital Ghent, Ghent, Belgium
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Brüner M, Dige A, Loft AG, Laurberg TB, Agnholt JS, Clemmensen K, McInnes I, Lories R, Iversen L, Hjuler KF, Kragstrup TW. Spondylitis-psoriasis-enthesitis-enterocolitis-dactylitis-uveitis-peripheral synovitis (SPEED-UP) treatment. Autoimmun Rev 2020; 20:102731. [PMID: 33326852 DOI: 10.1016/j.autrev.2020.102731] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 10/30/2020] [Indexed: 12/20/2022]
Abstract
Axial spondyloarthritis (axSpA), psoriatic arthritis (PsA), psoriasis, inflammatory bowel disease (IBD), and noninfectious uveitis form a distinct group among the immune mediated inflammatory diseases. Thus, many patients suffer from more than one of these disease manifestations. Here, we will use the term spondylitis-psoriasis-enthesitis-enterocolitis-dactylitis-uveitis-peripheral synovitis (SPEED-UP) spectrum disease. The aim is to review the new targeted pharmacological treatment options for all these diseases. All biological or targeted synthetic drugs with U.S. Food and Drug Administration (FDA) or European Medicines Agency (EMA) approval for any of the diagnoses axSpA, PsA, psoriasis, IBD, or non-infectious uveitis were included. Some of the drugs have documented efficacy in more than one of the diseases, e.g. tumor necrosis factor (TNF) inhibitors. However, other drugs are particularly effective for a specific inflamed tissue and approved in only one or two of the disease entities, e.g. abatacept for peripheral arthritis and vedolizumab for inflammatory bowel disease. This contributes with bedside to bench understanding of the immunology underlying this disease spectrum and provides clinicians with an overview that can assist stratified treatment decisions. We hope that this review will help guide clinicians to speed up treatment of patients with this disease spectrum.
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Affiliation(s)
- Mads Brüner
- National Center of Autoimmune Diseases, Aarhus University Hospital, Denmark; Department of Biomedicine, Aarhus University, Denmark
| | - Anders Dige
- National Center of Autoimmune Diseases, Aarhus University Hospital, Denmark; Department of Hepatology and Gastroenterology, Aarhus University Hospital, Denmark
| | - Anne Gitte Loft
- National Center of Autoimmune Diseases, Aarhus University Hospital, Denmark; Department of Rheumatology, Aarhus University Hospital, Denmark
| | - Trine Bay Laurberg
- National Center of Autoimmune Diseases, Aarhus University Hospital, Denmark; Department of Rheumatology, Aarhus University Hospital, Denmark
| | - Jørgen Steen Agnholt
- National Center of Autoimmune Diseases, Aarhus University Hospital, Denmark; Department of Hepatology and Gastroenterology, Aarhus University Hospital, Denmark
| | - Kåre Clemmensen
- Department of Ophthalmology, Aarhus University Hospital, Denmark
| | - Iain McInnes
- Institute of Infection, Immunity and Inflammation, University of Glascow, Denmark
| | - Rik Lories
- Skeletal Biology and Engineering Research Center, KU Leuven, Denmark
| | - Lars Iversen
- National Center of Autoimmune Diseases, Aarhus University Hospital, Denmark; Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark
| | - Kasper Fjellhaugen Hjuler
- National Center of Autoimmune Diseases, Aarhus University Hospital, Denmark; Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark.
| | - Tue Wenzel Kragstrup
- National Center of Autoimmune Diseases, Aarhus University Hospital, Denmark; Department of Biomedicine, Aarhus University, Denmark; Department of Rheumatology, Aarhus University Hospital, Denmark.
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5
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Park JJ. Mechanism-based Drug Therapy of Inflammatory Bowel Disease With Special Reference to Rheumatic Disease. JOURNAL OF RHEUMATIC DISEASES 2020. [DOI: 10.4078/jrd.2020.27.3.128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Jae Jun Park
- Division of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
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6
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Dupré A, Collins M, Nocturne G, Carbonnel F, Mariette X, Seror R. Articular manifestations in patients with inflammatory bowel disease treated with vedolizumab. Rheumatology (Oxford) 2020; 59:3275-3283. [DOI: 10.1093/rheumatology/keaa107] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 02/13/2020] [Indexed: 12/13/2022] Open
Abstract
Abstract
Objective
Vedolizumab (VDZ) has been incriminated in the occurrence of articular manifestations in patients with inflammatory bowel diseases (IBDs). The aim of this study was to describe musculoskeletal manifestations occurring in IBD patients treated by VDZ and to identify risk factors.
Methods
In this retrospective monocentric study, we included all consecutive patients treated by VDZ for IBD in our hospital. Incident musculoskeletal manifestations occurring during VDZ treatment were analysed and characteristics of patients with and without articular inflammatory manifestations were compared.
Results
Between 2013 and 2017, 112 patients were treated with VDZ for IBD: ulcerative colitis (n = 59), Crohn’s disease (n = 49) and undetermined colitis (n = 4). Four patients (3.6%) had a history of SpA, whereas 13 (11.6%) had a history of peripheral arthralgia. Some 102 (91.1%) patients had previously received anti-TNF. After a mean (S.d.) follow-up of 11.4 (8.6) months, 32 (28.6%) patients presented 35 musculoskeletal manifestations, of which 18 were mechanical and 17 inflammatory. Among the latter, 11 had axial or peripheral SpA, 5 had early reversible arthralgia and 1 had chondrocalcinosis (n = 1). Among the 11 SpA patients, only 3 (2.6%) had inactive IBD and may be considered as paradoxical SpA. The only factor associated with occurrence of inflammatory manifestations was history of inflammatory articular manifestation [7/16 (43.8%) vs 10/80 (12.5%), P = 0.007].
Conclusion
Musculoskeletal manifestations occurred in almost 30% of IBD patients treated with VDZ, but only half of them were inflammatory. Since most of the patients previously received anti-TNF, occurrence of inflammatory articular manifestations might rather be linked to anti-TNF discontinuation than to VDZ itself.
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Affiliation(s)
- Anastasia Dupré
- Department of Rheumatology, INSERM UMR1184, Université Paris-Saclay, Le Kremlin Bicêtre, France
| | - Michael Collins
- Department of Gastroenterology, Université Paris-Sud, AP-HP, Université Paris-Saclay, Le Kremlin Bicêtre, France
| | - Gaétane Nocturne
- Department of Rheumatology, INSERM UMR1184, Université Paris-Saclay, Le Kremlin Bicêtre, France
| | - Franck Carbonnel
- Department of Gastroenterology, Université Paris-Sud, AP-HP, Université Paris-Saclay, Le Kremlin Bicêtre, France
| | - Xavier Mariette
- Department of Rheumatology, INSERM UMR1184, Université Paris-Saclay, Le Kremlin Bicêtre, France
| | - Raphaèle Seror
- Department of Rheumatology, INSERM UMR1184, Université Paris-Saclay, Le Kremlin Bicêtre, France
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7
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Romero-López JP, Gómez-Martínez D, Domínguez-López ML, Jiménez-Zamudio L, Casasola-Vargas JC, Burgos-Vargas R, García-Latorre E. Differential expression of TLR2 and TLR4 in α4β7-positive leukocytes of patients with axial spondyloarthritis. Rheumatology (Oxford) 2020; 59:879-888. [PMID: 31578573 DOI: 10.1093/rheumatology/kez364] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 07/16/2019] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES Expression of α4β7 integrin can identify gut-homing immune cells. This study aimed to determine the expression of Toll-like receptor 2 (TLR2) and TLR4 in α4β7-positive leukocytes of patients with axial SpA (axSpA). METHODS We analysed the frequencies of α4β7-positive T cells, Tγδ cells and monocytes in 14 patients with axSpA and 14 healthy controls, together with the expression of TLR2 and TLR4 by flow cytometry. Also, the concentration of faecal calprotectin was measured in all patients and controls. RESULTS We found significantly higher percentages of α4β7-positive T (P = 0.026) and Tγδ cells (P = 0.0118) in the patients with axSpA than in controls; these cells showed differential expression of TLR2 and TLR4 when compared with α4β7-negative cells. Such differences were not correlated with disease activity or faecal calprotectin concentration. CONCLUSION There is an increase in circulating α4β7-positive T and Tγδ cells in patients with axSpA. These cells differentially express TLR2 and TLR4.
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Affiliation(s)
- José Pablo Romero-López
- Laboratorio de Inmunoquímica I, Posgrado en Ciencias Quimicobiológicas, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional
| | - David Gómez-Martínez
- Laboratorio de Inmunoquímica I, Posgrado en Ciencias Quimicobiológicas, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional
| | - María Lilia Domínguez-López
- Laboratorio de Inmunoquímica I, Posgrado en Ciencias Quimicobiológicas, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional
| | - Luis Jiménez-Zamudio
- Laboratorio de Inmunoquímica I, Posgrado en Ciencias Quimicobiológicas, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional
| | | | - Rubén Burgos-Vargas
- Departamento de Reumatología, Hospital General de México "Dr. Eduardo Liceaga," Ciudad de México, México
| | - Ethel García-Latorre
- Laboratorio de Inmunoquímica I, Posgrado en Ciencias Quimicobiológicas, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional
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8
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Chateau T, Bonovas S, Le Berre C, Mathieu N, Danese S, Peyrin-Biroulet L. Vedolizumab Treatment in Extra-Intestinal Manifestations in Inflammatory Bowel Disease: A Systematic Review. J Crohns Colitis 2019; 13:1569-1577. [PMID: 31076751 DOI: 10.1093/ecco-jcc/jjz095] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND AIMS We aimed to summarize existing data on the effectiveness of vedolizumab in extra-intestinal manifestations [EIMs] in inflammatory bowel disease [IBD]. METHODS We conducted a systematic literature search in PubMed and the Cochrane Library, up to October 2018. Interventional and non-interventional studies as well as case-series studying vedolizumab and EIMs in adult patients with IBD were considered eligible. RESULTS Three interventional studies [one randomized trial, n = 1032; and two open-label trials, n = 347], five non-interventional studies [n = 1496] and three case-series [n = 17] were included. Vedolizumab did not show any effectiveness in primary sclerosing cholangitis [PSC]. While no effect was seen in pre-existing manifestations regarding arthralgia and arthritis, the occurrence of new rheumatic symptoms was lower among vedolizumab users compared to placebo; occurrence was higher, however, with vedolizumab than with tumour necrosis factor inhibitors. Finally, vedolizumab appears not to be efficacious for the treatment of cutaneous manifestations. CONCLUSIONS There is no strong evidence to suggest that vedolizumab may be efficacious for the treatment of pre-existing EIMs [especially PSC, rheumatic and cutaneous manifestations], although it may reduce the occurrence of new EIMs.
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Affiliation(s)
- Thomas Chateau
- Department of Hepato-Gastroenterology, University Hospital of Grenoble, University of Grenoble Alpes, Grenoble, France
| | - Stefanos Bonovas
- Department of Biomedical Sciences, Humanitas University, Milan, Italy.,IBD Center, Humanitas Clinical and Research Center, Milan, Italy
| | - Catherine Le Berre
- Institut des Maladies de l'Appareil Digestif, Nantes University Hospital, Nantes, France.,Department of Hepato-Gastroenterology and Inserm U954, University Hospital of Nancy, University of Lorraine, Vandoeuvre-lès-Nancy, France
| | - Nicolas Mathieu
- Department of Hepato-Gastroenterology, University Hospital of Grenoble, University of Grenoble Alpes, Grenoble, France
| | - Silvio Danese
- Department of Biomedical Sciences, Humanitas University, Milan, Italy.,IBD Center, Humanitas Clinical and Research Center, Milan, Italy
| | - Laurent Peyrin-Biroulet
- Department of Hepato-Gastroenterology and Inserm U954, University Hospital of Nancy, University of Lorraine, Vandoeuvre-lès-Nancy, France
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9
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Romano C, Esposito S, Ferrara R, Cuomo G. Choosing the most appropriate biologic therapy for Crohn’s disease according to concomitant extra-intestinal manifestations, comorbidities, or physiologic conditions. Expert Opin Biol Ther 2019; 20:49-62. [DOI: 10.1080/14712598.2020.1689953] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Ciro Romano
- Division of Internal Medicine, Department of Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Sergio Esposito
- Division of Internal Medicine, Department of Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Roberta Ferrara
- Division of Internal Medicine, Department of Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Giovanna Cuomo
- Division of Internal Medicine, Department of Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
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10
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Paccou J, Nachury M, Duchemin C, Desreumaux P, Flipo RM, Pariente B. Vedolizumab has no efficacy on articular manifestations in patients with spondyloarthritis associated with inflammatory bowel disease. Joint Bone Spine 2019; 86:654-656. [DOI: 10.1016/j.jbspin.2019.01.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Accepted: 01/22/2019] [Indexed: 01/13/2023]
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11
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García-Vicuña R, Brown MA. Vedolizumab for inflammatory bowel disease: a two-edge sword in the gut-joint/enthesis axis. Rheumatology (Oxford) 2019; 58:937-939. [DOI: 10.1093/rheumatology/key440] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 11/04/2018] [Indexed: 12/25/2022] Open
Affiliation(s)
| | - Matthew A Brown
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Translational Research Institute, Princess Alexandra Hospital, Brisbane, Queensland, Australia
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12
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Letter to editor: New onset/recurrence of inflammatory arthralgia/spondyloarthritis in patients treated with vedolizumab for intestinal bowel disease. Clin Rheumatol 2018; 38:609-610. [DOI: 10.1007/s10067-018-4357-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 10/22/2018] [Accepted: 10/29/2018] [Indexed: 01/26/2023]
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13
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Dubash S, Marianayagam T, Tinazzi I, Al-Araimi T, Pagnoux C, Weizman AV, Richette P, Tran Minh ML, Allez M, Singh A, Ciccia F, Hamlin J, Tan AL, Marzo-Ortega H, McGonagle D. Emergence of severe spondyloarthropathy-related entheseal pathology following successful vedolizumab therapy for inflammatory bowel disease. Rheumatology (Oxford) 2018; 58:963-968. [DOI: 10.1093/rheumatology/key267] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 07/19/2018] [Indexed: 01/15/2023] Open
Affiliation(s)
- Sayam Dubash
- Department of Rheumatology, NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, UK
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
| | | | - Ilaria Tinazzi
- Division of General Medicine, Rheumatology Unit, Sacro Cuore-Don Calabria Hospital, Negrar, Italy
| | - Tariq Al-Araimi
- Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Canada
| | - Christian Pagnoux
- Division of Rheumatology, Department of Medicine, University of Toronto, Toronto, Canada
| | - Adam V Weizman
- Division of Gastroenterology, Mount Sinai Hospital, Department of Medicine, University of Toronto, Toronto, Canada
| | - Pascal Richette
- Lariboisiere Hospital, Rheumatology Department, APHP, University of Paris, Diderot, France
| | - My-Linh Tran Minh
- Department of Gastroenterology, APHP, Saint Louis Hospital, Paris Diderot, Sorbonne Paris-Cité University, Paris, France
| | - Matthieu Allez
- Department of Gastroenterology, APHP, Saint Louis Hospital, Paris Diderot, Sorbonne Paris-Cité University, Paris, France
| | - Animesh Singh
- Department of Rheumatology, Royal Free Hospital, London, UK
| | - Francesco Ciccia
- Dipartimento Biomedico di Medicina Interna e Specialistica, Sezione di Reumatologia, Università degli studi di Palermo, Palermo, Italy
| | - John Hamlin
- Department of Gastroenterology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Ai Lyn Tan
- Department of Rheumatology, NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, UK
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
| | - Helena Marzo-Ortega
- Department of Rheumatology, NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, UK
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
| | - Dennis McGonagle
- Department of Rheumatology, NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, UK
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
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Felice C, Pugliese D, Papparella LG, Pizzolante F, Onori E, Gasbarrini A, Rapaccini GL, Guidi L, Armuzzi A. Clinical management of rheumatologic conditions co-occurring with inflammatory bowel diseases. Expert Rev Clin Immunol 2018; 14:751-759. [DOI: 10.1080/1744666x.2018.1513329] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Carla Felice
- IBD Unit, Presidio Columbus, Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Daniela Pugliese
- IBD Unit, Presidio Columbus, Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Luigi Giovanni Papparella
- IBD Unit, Presidio Columbus, Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Fabrizio Pizzolante
- IBD Unit, Presidio Columbus, Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Eugenia Onori
- Dipartimento di Medicina Interna, Università degli studi dell’Aquila, L’Aquila, Italy
| | - Antonio Gasbarrini
- Department of Internal Medicine, Gastroenterology Division, Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Gian Lodovico Rapaccini
- IBD Unit, Presidio Columbus, Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Luisa Guidi
- IBD Unit, Presidio Columbus, Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Alessandro Armuzzi
- IBD Unit, Presidio Columbus, Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
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15
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Dubinsky MC, Cross RK, Sandborn WJ, Long M, Song X, Shi N, Ding Y, Eichner S, Pappalardo B, Ganguli A, Wang A. Extraintestinal Manifestations in Vedolizumab and Anti-TNF-Treated Patients With Inflammatory Bowel Disease. Inflamm Bowel Dis 2018; 24:1876-1882. [PMID: 29668916 DOI: 10.1093/ibd/izy065] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND Extra-intestinal manifestations (EIMs) can impact morbidity in patients with inflammatory bowel diseases (IBD; Crohn's disease [CD] and ulcerative colitis [UC]). This study compared incidence rates of EIMs in patients with moderate to severe IBD receiving gut-selective vedolizumab (VDZ) vs those receiving systemic anti-tumor necrosis factor (anti-TNF) therapies. METHODS Adult IBD patients receiving VDZ or anti-TNFs were identified from the MarketScan claims database from September 28, 2012, through September 30, 2016. Incidence rates of EIMs were compared between the 2 cohorts. Descriptive analyses were performed for all courses of treatment. Generalized linear models estimated the impact of treatment on the likelihood of developing EIMs. RESULTS Compared with patients receiving anti-TNF therapy, VDZ-treated CD patients were 28% more likely to develop "any EIMs" (adjusted incident rate ratio [IRR], 1.28; 95% confidence interval [CI], 1.02-1.62). Specifically, CD patients treated with VDZ were more likely to develop erythema nodosum (IRR, 4.29; 95% CI, 1.73-10.64), aphthous stomatitis (IRR, 3.73; 95% CI, 1.51-9.23), episcleritis/scleritis (IRR, 2.51; 95% CI, 1.02-6.14), arthropathy (IRR, 1.45; 95% CI, 1.15-1.84), primary sclerosing cholangitis (PSC) (IRR, 7.79; 95% CI, 3.32-18.27), and uveitis/iritis (IRR, 2.89; 95% CI, 1.35-6.18). UC patients receiving VDZ did not have a statistically significant increase in "any EIMs" vs patients receiving anti-TNFs, but were more likely to develop specific EIMs (aphthous stomatitis: IRR, 3.67; 95% CI, 1.30-10.34; pyoderma gangrenosum: IRR, 4.42; 95% CI, 1.00-19.45; and PSC: IRR, 3.44; 95% CI, 1.23-9.68). CONCLUSIONS IBD patients receiving VDZ may be more likely to develop EIMs vs patients receiving anti-TNF therapies. The gut-selective inflammatory control of VDZ may potentially limit its clinical effect on EIM prevention.
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Affiliation(s)
| | - Raymond K Cross
- University of Maryland School of Medicine, Baltimore, Maryland
| | | | - Millie Long
- Universtiy of North Carolina, Chapel Hill, Chapel Hill, North Carolina
| | - Xue Song
- Truven Health Analytics, Cambridge, Massachusetts
| | - Nianwen Shi
- Truven Health Analytics, Cambridge, Massachusetts
| | - Yao Ding
- Truven Health Analytics, Cambridge, Massachusetts
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16
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Laurence M, Asquith M, Rosenbaum JT. Spondyloarthritis, Acute Anterior Uveitis, and Fungi: Updating the Catterall-King Hypothesis. Front Med (Lausanne) 2018; 5:80. [PMID: 29675414 PMCID: PMC5895656 DOI: 10.3389/fmed.2018.00080] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 03/09/2018] [Indexed: 12/12/2022] Open
Abstract
Spondyloarthritis is a common type of arthritis which affects mostly adults. It consists of idiopathic chronic inflammation of the spine, joints, eyes, skin, gut, and prostate. Inflammation is often asymptomatic, especially in the gut and prostate. The HLA-B*27 allele group, which presents intracellular peptides to CD8+ T cells, is by far the strongest risk factor for spondyloarthritis. The precise mechanisms and antigens remain unknown. In 1959, Catterall and King advanced a novel hypothesis explaining the etiology of spondyloarthritis: an as-yet-unrecognized sexually acquired microbe would be causing all spondyloarthritis types, including acute anterior uveitis. Recent studies suggest an unrecognized sexually acquired fungal infection may be involved in prostate cancer and perhaps multiple sclerosis. This warrants reanalyzing the Catterall-King hypothesis based on the current literature. In the last decade, many links between spondyloarthritis and fungal infections have been found. Antibodies against the fungal cell wall component mannan are elevated in spondyloarthritis. Functional polymorphisms in genes regulating the innate immune response against fungi have been associated with spondyloarthritis (CARD9 and IL23R). Psoriasis and inflammatory bowel disease, two common comorbidities of spondyloarthritis, are both strongly associated with fungi. Evidence reviewed here lends credence to the Catterall-King hypothesis and implicates a common fungal etiology in prostate cancer, benign prostatic hyperplasia, multiple sclerosis, psoriasis, inflammatory bowel disease, and spondyloarthritis. However, the evidence available at this time is insufficient to definitely confirm this hypothesis. Future studies investigating the microbiome in relation to these conditions should screen specimens for fungi in addition to bacteria. Future clinical studies of spondyloarthritis should consider antifungals which are effective in psoriasis and multiple sclerosis, such as dimethyl fumarate and nystatin.
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Affiliation(s)
| | - Mark Asquith
- Division of Arthritis and Rheumatic Diseases, Oregon Health & Science University, Portland, OR, United States
| | - James T Rosenbaum
- Department of Ophthalmology, Oregon Health and Science University, Portland, OR, United States.,Department of Medicine, Oregon Health and Science University, Portland, OR, United States.,Department of Cell Biology, Oregon Health and Science University, Portland, OR, United States.,Legacy Devers Eye Institute, Portland, OR, United States
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17
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Tadbiri S, Peyrin-Biroulet L, Serrero M, Filippi J, Pariente B, Roblin X, Buisson A, Stefanescu C, Trang-Poisson C, Altwegg R, Marteau P, Vaysse T, Bourrier A, Nancey S, Laharie D, Allez M, Savoye G, Gilletta C, Gagniere C, Vuitton L, Viennot S, Aubourg A, Pelletier AL, Bouguen G, Abitbol V, Fumery M, Claudepierre P, Bouhnik Y, Amiot A. Impact of vedolizumab therapy on extra-intestinal manifestations in patients with inflammatory bowel disease: a multicentre cohort study nested in the OBSERV-IBD cohort. Aliment Pharmacol Ther 2018; 47:485-493. [PMID: 29250803 DOI: 10.1111/apt.14419] [Citation(s) in RCA: 80] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2017] [Revised: 08/26/2017] [Accepted: 10/26/2017] [Indexed: 12/31/2022]
Abstract
BACKGROUND The effectiveness of vedolizumab as a treatment for extraintestinal manifestations (EIM) is questionable due to its gut-specificity. AIM To assess effectiveness of vedolizumab for EIM in patients with inflammatory bowel disease (IBD) in a large real-life experience cohort. METHODS Between June and December 2014, 173 patients with Crohn's disease and 121 with ulcerative colitis were treated with vedolizumab. Patients were followed until week 54. EIM activity was assessed at weeks 0, 6, 14, 22, 30 and 54 by using a 3-step scale: complete remission, partial response and no response. RESULTS At baseline, 49 (16.7%) patients had EIMs of which 47 had inflammatory arthralgia/arthritis, four had cutaneous lesions and two had both rheumatologic and skin EIM. At week 54, 21 (44.7%) patients had complete remission for inflammatory arthralgia/arthritis and three (75%) for cutaneous EIM. In multivariate analysis, complete remission of inflammatory arthralgia/arthritis was associated with clinical remission of IBD (OR = 1.89, IC95% [1.05-3.41], P = .03) and recent onset of inflammatory arthralgia/arthritis (OR = 1.99, IC95% [1.12-3.52], P = .02). During the follow-up period, 34 (13.8%) patients without any EIM at baseline, developed incident cases of inflammatory arthralgia/arthritis consisting mostly of peripheral arthralgia without evidence of arthritis and 14 (4.8%) incident cases of paradoxical skin manifestation. CONCLUSION Vedolizumab therapy is commonly associated with improvement in EIM. This was associated with quiescent IBD and recent EIM. However, paradoxical skin manifestation and inflammatory arthralgia/arthritis may occur upon vedolizumab therapy.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - P Marteau
- Lariboisière hospital, Paris, France
| | | | | | | | | | - M Allez
- Saint Louis hospital, Paris, France
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