NICE guidance - Vedolizumab for treating moderately to severely active ulcerative colitis

NICE guidance states (1):

• Vedolizumab
  • is recommended, within its marketing authorisation, as an option for treating moderately to severely active ulcerative colitis in adults only if the company provides vedolizumab with the discount agreed in the patient access scheme
  • should be given until it stops working or surgery is needed. At 12 months after the start of treatment, people should be reassessed to see whether treatment should continue. Treatment should only continue if there is clear evidence of ongoing clinical benefit. For people in complete remission at 12 months, consider stopping vedolizumab, resuming treatment if there is a relapse. People who continue vedolizumab should be reassessed at least every 12 months to see whether continued treatment is justified

Vedolizumab (1,2,3):

• such a selective blockade of the integrins can prevent the translocation of the lymphocytes into the inflamed gastrointestinal mucosa, thereby, reducing local inflammation. Vedolizumab (VDZ), a humanized IgG1 monoclonal antibody against alpha4beta7 integrin, inhibits the activity of the alpha4beta7 integrin in the blood vessels; thus, it can exert a therapeutic effect against ulcerative colitis (UC)
• VDZ is a safe and effective treatment option for patients with UC
  • prolonged VDZ induction therapy may contribute to improved outcomes in patients with UC, particularly those previously treated with tumor necrosis factor-alpha
• VDZ is an effective therapy for achieving durable remission in both patients with UC and CD (Crohn's disease) (3)
  • it has a favorable safety profile

Reference:

• NICE (5 June 2015).Vedolizumab for treating moderately to severely active ulcerative colitis ofacitinib for moderately to severely active ulcerative colitis
• Takatsu N, Hisabe T, Higashi D, Ueki T, Matsui T. Vedolizumab in the Treatment of Ulcerative Colitis: An Evidence-Based Review of Safety, Efficacy, and Place of Therapy. Core Evid. 2020;15:7-20. Published 2020 Apr 1. doi:10.2147/CE.S179053
• Battat R, Dulai PS, Jairath V, Vande Casteele N. A product review of vedolizumab in inflammatory bowel disease. Hum Vaccin Immunother. 2019;15(10):2482-2490. doi:10.1080/21645515.2019.1591139