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Reply to comment on: “Vedolizumab as the first line of biologic therapy for ulcerative colitis and Crohn's disease – a systematic review with meta-analysis”

  • Mohamed Attauabi
    Correspondence
    Corresponding author at: Gastrounit, Medical Division, Copenhagen University Hospital, Hvidovre, Denmark.
    Affiliations
    Gastrounit, Medical Division, Copenhagen University Hospital, Hvidovre, Denmark

    Copenhagen Center for Inflammatory Bowel Disease in Children, adolescents and adults, University of Copenhagen, Hvidovre Hospital, Denmark

    Department of Gastroenterology and Hepatology, Herlev Hospital, University of Copenhagen, Denmark
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  • Jakob Benedict Seidelin
    Affiliations
    Department of Gastroenterology and Hepatology, Herlev Hospital, University of Copenhagen, Denmark
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  • Johan Burisch
    Affiliations
    Gastrounit, Medical Division, Copenhagen University Hospital, Hvidovre, Denmark

    Copenhagen Center for Inflammatory Bowel Disease in Children, adolescents and adults, University of Copenhagen, Hvidovre Hospital, Denmark
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Published:December 01, 2022DOI:https://doi.org/10.1016/j.dld.2022.11.009
      We thank Dr. Kakiuchi and his colleague for their comments on our article, entitled Vedolizumab as the first line of biologic therapy for ulcerative colitis and Crohn's disease –a systematic review with meta-analysis [
      • Attauabi M.
      • Madsen G.R.
      • Bendtsen F.
      • Seidelin J.B.
      • Burisch J.
      Vedolizumab as the first line of biologic therapy for ulcerative colitis and Crohn's disease - a systematic review with meta-analysis.
      ]. Tumor necrosis factor-α (TNF) antagonists have historically been used as the first line of biological therapy for moderate-to-severe ulcerative colitis (UC) and Crohn's disease (CD) due to their first development and approval. However, several factors necessitate considerations of alternative treatment options, including contraindications towards TNF antagonists, as approximately two thirds of patients either do not attain or maintain remission one year after TNF antagonist initiation, [
      • Colombel J.
      • Sandborn W.
      • Rutgeerts P.
      • et al.
      Adalimumab for maintenance of clinical response and remission in patients with Crohn's disease: the CHARM trial.
      ,
      • Zhao M.
      • Sall Jensen M.
      • Knudsen T.
      • et al.
      Trends in the use of biologicals and their treatment outcomes among patients with inflammatory bowel diseases - a Danish nationwide cohort study.
      as well as a lower efficacy of subsequent biological therapies after exposure to TNF antagonists [
      • Sands B.E.
      • Feagan B.G.
      • Rutgeerts P.
      • et al.
      Effects of vedolizumab induction therapy for patients with Crohn's disease in whom tumor necrosis factor antagonist treatment failed.
      ].
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      References

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        Vedolizumab as the first line of biologic therapy for ulcerative colitis and Crohn's disease - a systematic review with meta-analysis.
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      Linked Article

      • More evidence is needed on the additional efficacy of vedolizumab as a first-line biologic therapy for inflammatory bowel disease
        Digestive and Liver DiseaseVol. 55Issue 2
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          With great interest, we read a systemic review and meta-analysis by Attauabi et al. [1], suggesting that vedolizumab has a favorable efficacy and safety profile in bio-naïve patients with ulcerative colitis (UC) and Crohn's disease than bio-exposed patients. Vedolizumab is a highly safe biologic that selectively acts in the intestinal tract; thus, systemic side reactions are considered unlikely [2]. Patients at higher risk for serious infections, such as children, the elderly, or patients with chronic lung disease, may benefit more from vedolizumab treatment than from immunosuppressants, corticosteroids, or tumor necrosis factor-α (TNF-α) antagonists [3].
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