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Correspondence| Volume 50, ISSUE 4, P415-417, April 2018

Combination therapy with cytapheresis plus vedolizumab in a corticosteroid-dependent patient with ulcerative colitis and previous ANTI-TNF-α drug failure

  • Esteban Sáez-González
    Affiliations
    Gastroenterology Department, La Fe University and Polytechnic Hospital, Valencia, Spain

    Inflammatory Bowel Disease Research Group, IIS Hospital La Fe, Valencia, Spain
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  • Mariam Aguas
    Affiliations
    Gastroenterology Department, La Fe University and Polytechnic Hospital, Valencia, Spain

    Inflammatory Bowel Disease Research Group, IIS Hospital La Fe, Valencia, Spain

    Networked Biomedical Research Center for Hepatic and Digestive Diseases (CIBEREHD), Barcelona, Spain
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  • José M. Huguet
    Affiliations
    Inflammatory Bowel Disease Unit, Department of Digestive Diseases, University General Hospital of Valencia, Spain
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  • Pilar Nos
    Correspondence
    Corresponding author at: Inflammatory Bowel Disease Unit and Inflammatory Bowel Disease Research Group, Gastroenterology Department, La Fe University and Polytechnic Hospital, Valencia, Spain.
    Affiliations
    Gastroenterology Department, La Fe University and Polytechnic Hospital, Valencia, Spain

    Inflammatory Bowel Disease Research Group, IIS Hospital La Fe, Valencia, Spain

    Networked Biomedical Research Center for Hepatic and Digestive Diseases (CIBEREHD), Barcelona, Spain
    Search for articles by this author
  • Belén Beltrán
    Affiliations
    Gastroenterology Department, La Fe University and Polytechnic Hospital, Valencia, Spain

    Inflammatory Bowel Disease Research Group, IIS Hospital La Fe, Valencia, Spain

    Networked Biomedical Research Center for Hepatic and Digestive Diseases (CIBEREHD), Barcelona, Spain
    Search for articles by this author
Published:February 02, 2018DOI:https://doi.org/10.1016/j.dld.2018.01.124
Combination therapy with cytapheresis plus vedolizumab in a corticosteroid-dependent patient with ulcerative colitis and previous ANTI-TNF-α drug failure
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Next ArticleUpfront Alcian Blue-periodic acid Schiff stain for the assessment of upper gastrointestinal disorders
      Ulcerative colitis (UC) is a chronic, relapsing gastrointestinal disorder characterised by inflammation of the colonic mucosa [
      • Magro F.
      • Gionchetti P.
      • Eliakim R.
      • Ardizzone S.
      • Armuzzi A.
      • Barreiro-de Acosta M.
      • et al.
      Third European evidence-based consensus on diagnosis and management of ulcerative colitis. Part 1: definitions, diagnosis, extra-intestinal manifestations, pregnancy, cancer surveillance, surgery, and ileo-anal pouch disorders.
      J Crohns Colitis. 2017; 11: 649-670
      ]. The therapeutic goal of UC treatments is to induce steroid-free clinical remission, which is defined as the complete resolution of symptoms, with stool frequency ≤3/d without bleeding or urgency and endoscopy without mucosal lesions [
      • Harbord M.
      • Eliakim R.
      • Bettenworth D.
      • Karmiris K.
      • Katsanos K.
      • Kopylov U.
      • et al.
      Third European evidenced-based consensus on diagnosis and management of ulcerative colitis: part 2: current management.
      J Crohns Colitis. 2017; 11: 769-784
      ]. Common therapeutic agents used to control disease activity include 5-aminosalicylate compounds, steroids, immunosuppressants (thiopurines), calcineurin inhibitors (cyclosporine, tacrolimus), and biologic drugs such as anti-tumour necrosis factor (TNF)-α (infliximab/adalimumab) and the anti-adhesion molecule vedolizumab. Biologic therapies with anti-TNF-α drugs have demonstrated their efficacy in the induction and maintenance of remission for the treatment of UC. However, there is a subgroup of patients who do not respond adequately to these treatments. In this clinical setting, alternative treatments or colectomy should be considered [
      • Magro F.
      • Gionchetti P.
      • Eliakim R.
      • Ardizzone S.
      • Armuzzi A.
      • Barreiro-de Acosta M.
      • et al.
      Third European evidence-based consensus on diagnosis and management of ulcerative colitis. Part 1: definitions, diagnosis, extra-intestinal manifestations, pregnancy, cancer surveillance, surgery, and ileo-anal pouch disorders.
      J Crohns Colitis. 2017; 11: 649-670
      ,
      • Harbord M.
      • Eliakim R.
      • Bettenworth D.
      • Karmiris K.
      • Katsanos K.
      • Kopylov U.
      • et al.
      Third European evidenced-based consensus on diagnosis and management of ulcerative colitis: part 2: current management.
      J Crohns Colitis. 2017; 11: 769-784
      ].
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      Article info

      Publication history

      Published online: February 02, 2018
      Received: November 27, 2017

      Identification

      DOI: https://doi.org/10.1016/j.dld.2018.01.124

      Copyright

      © 2018 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

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