Vedolizumab: medicine against Crohn’s disease

The drug Vedolizumab could perhaps offer a solution for the many tens of thousands of patients with Crohn’s disease in the Netherlands. It is the first drug that penetrates exactly into the intestines where the inflammation in this condition occurs without immediately suppressing the rest of the immune system.

Vedolizumab in Crohn’s disease

• Crohn’s disease
• Symptoms of Crohn’s disease
• How is Crohn’s disease controlled?
• Vedolizumab, hope for Crohn’s patients?

Crohn’s disease

Crohn’s disease is an inflammatory disease of the intestinal tract . A large part of the inflammation occurs during the transition from the small intestine to the large intestine, but it can also manifest itself in all kinds of other places in the intestinal tract. It is a very unpredictable condition. While you may sometimes have relatively few complaints for years, they can suddenly flare up again and a hospital stay and possibly surgical intervention may become necessary.

Symptoms of Crohn’s disease

Complaints associated with Crohn’s disease are:
An inability of the intestine to absorb sufficient fluid, resulting in (water-thin) diarrhea

• Blood in the stool due to wounds in the intestinal tract
• Deficiency of certain nutrients due to insufficient absorption by the intestines, which can result in, among other things, anemia, weight loss and growth retardation in children.
• Narrowing and closure of the intestine due to scar tissue

Some less common complaints that can sometimes be related to Crohn’s disease include the formation of fistulas, joint pain, eye disorders and skin disorders.

How is Crohn’s disease controlled?

Patients with Crohn’s disease are usually prescribed anti-inflammatory medications to suppress existing inflammation and prevent new ones from developing. In addition, medication may be prescribed to suppress other symptoms such as diarrhea and anemia. Which medicines work best varies per patient. Everyone will look for the best combination of resources with his or her specialist. For example, one patient may benefit more from a drug that acts on the small intestine, while for another a drug that acts on the large intestine has a better effect.

Commonly used remedies in the Netherlands to combat the symptoms of Crohn’s disease are:

• Adalimumab (Humira)
• Asacol
• Azathioprine
• Budesonide
• Ciprofloxacin
• Cortiment
• Depomedrol
• Dexamethasone
• Emthexate
• Imuran
• Infliximab
• Lodotra
• Mercaptopurine
• Mesalazine (Claversal, Salofalk and Pentasa)
• Methotrexate
• Metronidazole
• Prednisone and Prednisolone
• Puri-nethol
• Remicade
• Rifampicin
• Sulfasalazine (Salazopyrine)
• Tavanic
• Tazocin
• Tiberal
• Triamcinolone
• Xaluprine

Vedolizumab, hope for Crohn’s patients?

Scientists all over the world are conducting research into remedies that can effectively combat this condition. Due to the large number of patients worldwide, there is no need to complain about a lack of attention to the condition. The Japanese pharmaceutical company Tekada UK may have made a breakthrough in this regard with the development of the drug Vedolizumab .

This concerns a so-called TNF-alpha inhibitor , which also includes drugs such as Adalimumab and Infliximab. These agents inhibit a specific molecule (cytokine) that can play a role in inflammatory reactions. They have been used since the 1990s, but the development of Vedolizumab has been one of the biggest breakthroughs since then. The special thing about Vedolizumab is that instead of suppressing the entire immune system, it only acts on the intestines. This is much better for the overall health of patients. Insurers have to dig deep into their pockets for this. A treatment with Vedolizumab costs about 15,000 euros. It must be given by infusion every eight weeks.

The drug was tested in England, where a total of 2,700 subjects with Crohn’s disease were administered this drug or a placebo. 40% of Vedolizumab users remained symptom-free : twice as many as in the control group that received a placebo. This indicates that a significant proportion of test subjects respond well to the new drug. In addition, it has also been shown that damaged tissue on the inside of the intestines can recover.