Inflammatory bowel diseases are immune mediated inflammatory disorders of the digestive tract, induced and maintained by T lymphocytes dysregulation, with genetic background and dysbiosis of the gut microbiota with environment influence. Crohn’s disease frequently causes structural damage to the intestinal tract resulting in complications of stricture, fistula and abscess formation, loss of function. Patients require surgical therapy in addition to medication. Vedolizumab is a gut-selective monoclonal antibody against ɑ4β7 integrins with inhibiting vascular adhesion and migration of lymphocytes to intestinal mucosa. It is indicated for therapy of moderate to severe Crohn’s disease and ulcerative colitis.
In comparison with antiTNF infliximab, vedolizumab has similar effectivity with lower incidence of infectious adverse events and higher therapy persistence. Head to head comparing trial VARSITY (comparison of vedolizumab and adalimumab) demonstrates superior clinical and endoscopic efficacy of vedolizumab for the treatment of moderately to severely active ulcerative colitis, with early clinical response in week 14. Trial LOVE-CD and EVOLVE demonstrate higher rate of endoscopic response and remission in bio-naive patients. Bio-naive patients with Crohn’s disease and ulcerative colitis treated with vedolizumab achieved higher efficacy in comparison with antiTNF exposed and would be suitable for the first line biological en_option.