VEDOLIZUMAB FOR CROHN’S DISEASE
Vedolizumab is one of the newer biological treatments for IBD. Whereas Humira and Infliximab are called Anti-TNF drugs, this is a ‘gut-selective integrin blocker’ which targets white blood cells. White blood cells are made by the immune system to fight infection. In Crohn’s Disease and Ulcerative Colitis, overproduction of these cells leads to inflammation. Vedolizumab works by stopping the white blood cells from entering the lining of the gut. This means that the drug only targets the gut, rather than the whole of the body like anti-TNF drugs, and may cause fewer side effects.
Vedolizumab is given to treat adults with moderate to severe Crohn’s disease or Ulcerative Colitis. In both cases, Vedolizumab may be an option for you if other treatments such as steroids, 5-ASAs and immunosuppressants have not helped your condition. It also may be an option if you have tried an anti-TNF and it did not help your condition, or you are not able to take anti-TNF drugs because of your medical history. It is currently – 2017 – not licenced for use in children with Inflammatory Bowel Disease.
This is the medication I am currently on, in 2018.
Much like Infliximab, it has the same pre-starting checks – chest X-ray for TB, patient history to find out about infections, liver issues, cancer, immunisation and pregnancy in female patients. These are required to complete the funding application for this medication, like all biological treatments in IBD. Once approved, starting Vedolizumab is exactly like Infliximab; loading doses at week 0, week 2 and week 6. The medication is a set amount each time and infusions last between 60-90 minutes plus observation time. After the fourth infusion on week 10, the effectiveness of the drug is assessed and stopping or continuing treatment is recommended.
I have received Vedolizumab three times.
Firstly, between November 2015 and January 2016 prior to my first surgery.
Secondly after my second surgery, between September 2016 and February 2017.
And now, since September 2017.
On my first try, I did not respond as well as expected by week 10 and was given a week 14 booster with no luck. I decided at that point to pursue surgery and return to medication afterwards.
Following my ostomy surgery in August 2016, I returned to Vedolizumab for another 14 weeks and decided that due to my ‘remission’ I would go without medication. This was a massive underestimation of my disease, and I wound up in a huge flare up, needing Vedolizumab again. I am now in between my fourth and fifth infusion with no plans to stop this treatment at all.
I am very lucky to have had two wonderful IBD teams fighting my corner to get me the access to the funding for my medication. Without them, and without my biological treatments, I would have spent probably years in and out of hospital fighting flare up after flare up. Luckily, I’ve only had a couple of admissions for flare ups, and usually it was when I was without my medication. It just goes to prove that, despite the expense of biological treatment; estimated at between £12-15k per year per patient, I wouldn’t be able to have the life that I currently have or the life I have had. I am able to hold down a job, have a relationship, manage my own disease better, have become a better advocate for myself and my medical knowledge is stronger than ever.
My current experiences with Vedolizumab can be found here.