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Review Article

Vedolizumab in the Perioperative Management of Inflammatory Bowel Disease

Author(s): Amy L. Lightner*, Edward V. Loftus, Nicholas P. McKenna and Laura E. Raffals

Volume 20, Issue 13, 2019

Page: [1317 - 1322] Pages: 6

DOI: 10.2174/1389450120666190325130142

Price: $65

Abstract

Background: The isolated effect of vedolizumab on increased postoperative complications remains debated, similar to the controversial data on anti-TNF and postoperative complications.

Objective: To determine the risk of vedolizumab on postoperative complications.

Methods: A review of the literature available to date on studies comparing postoperative outcomes in vedolizumab-treated versus non-vedolizumab-treated patients was performed. Studies were stratified by those which combined all inflammatory bowel disease together, those specifically focusing on Crohn’s disease or ulcerative colitis individually, and those which included pediatric patients alone.

Results: The data remains controversial in both the adult and pediatric literature regarding the association of vedolizumab and increased postoperative complications. The strongest association between vedolizumab and an increased risk of postoperative infectious complications seems to be in the Crohn’s disease literature.

Conclusion: Vedolizumab may be associated with an increased risk of postoperative infectious complications in Crohn’s disease, but the literature remains controversial due to difficulty in isolating the effect of the biologic alone in a chronically ill, heterogeneous patient population who are on multiple medications including corticosteroids.

Keywords: Vedolizumab, inflammatory bowel disease, surgical intervention, postoperative infectious complications, intraabdominal sepsis, Crohn’s disease, ulcerative colitis.

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Graphical Abstract

[1]
Colombel JF, Sands BE, Rutgeerts P, et al. The safety of vedolizumab for ulcerative colitis and Crohn’s disease. Gut 2017; 66(5): 839-51.
[2]
Dave M, Purohit T, Razonable R, Loftus EV Jr. Opportunistic infections due to inflammatory bowel disease therapy. Inflamm Bowel Dis 2014; 20(1): 196-212.
[3]
Alves A, Panis Y, Bouhnik Y, et al. Risk factors for intra-abdominal septic complications after a first ileocecal resection for Crohn’s disease: a multivariate analysis in 161 consecutive patients. Dis Colon Rectum 2007; 50(3): 331-6.
[4]
Appau KA, Fazio VW, Shen B, et al. Use of infliximab within 3 months of ileocolonic resection is associated with adverse postoperative outcomes in Crohn’s patients. J Gastrointest Surg 2008; 12(10): 1738-44.
[5]
Bafford AC, Powers S, Ha C, et al. Immunosuppressive therapy does not increase operative morbidity in patients with Crohn’s disease. J Clin Gastroenterol 2013; 47(6): 491-5.
[6]
Billioud V, Ford AC, Tedesco ED, et al. Preoperative use of anti-TNF therapy and postoperative complications in inflammatory bowel diseases: a meta-analysis. J Crohn’s Colitis 2013; 7(11): 853-67.
[7]
Bregnbak D, Mortensen C, Bendtsen F. Infliximab and complications after colectomy in patients with ulcerative colitis. J Crohns Colitis 2012; 6(3): 281-6.
[8]
Brouquet A, Maggiori L, Zerbib P, et al. Anti-TNF therapy is associated with an increased risk of postoperative morbidity after surgery for ileocolonic crohn disease: results of a prospective nationwide cohort. Ann Surg 2018; 267(2): 221-8.
[9]
de Buck van Overstraeten A, Eshuis EJ, Vermeire S, et al. Short- and medium-term outcomes following primary ileocaecal resection for Crohn’s disease in two specialist centres. Br J Surg 2017; 104(12): 1713-22.
[10]
Eshuis EJ, Al Saady RL, Stokkers PC, et al. Previous infliximab therapy and postoperative complications after proctocolectomy with ileum pouch anal anastomosis. J Crohn’s Colitis 2013; 7(2): 142-9.
[11]
Fumery M, Seksik P, Auzolle C, et al. Postoperative complications after ileocecal resection in crohn’s disease: a prospective study from the remind group. Am J Gastroenterol 2017; 112(2): 337-45.
[12]
Indar AA, Young-Fadok TM, Heppell J, Efron JE. Effect of perioperative immunosuppressive medication on early outcome in Crohn’s disease patients. World J Surg 2009; 33(5): 1049-52.
[13]
Kopylov U, Ben-Horin S, Zmora O, Eliakim R, Katz LH. Anti-tumor necrosis factor and postoperative complications in Crohn’s disease: systematic review and meta-analysis. Inflamm Bowel Dis 2012; 18(12): 2404-13.
[14]
Morar PS, Hodgkinson JD, Thalayasingam S, et al. Determining predictors for intra-abdominal septic complications following ileocolonic resection for crohn’s disease-considerations in pre-operative and peri-operative optimisation techniques to improve outcome. J Crohn’s Colitis 2015; 9(6): 483-91.
[15]
Rizzo G, Armuzzi A, Pugliese D, et al. Anti-TNF-alpha therapies do not increase early postoperative complications in patients with inflammatory bowel disease. An Italian single-center experience. Int J Colorectal Dis 2011; 26(11): 1435-44.
[16]
Lightner AL, Raffals LE, Mathis KL, et al. Postoperative outcomes in vedolizumab-treated patients undergoing abdominal operations for inflammatory bowel disease. J Crohn’s Colitis 2017; 11(2): 185-90.
[17]
Lightner AL, Mathis KL, Tse CS, et al. Postoperative outcomes in vedolizumab-treated patients undergoing major abdominal operations for inflammatory bowel disease: Retrospective multicenter cohort study. Inflamm Bowel Dis 2018; 24: 871-6.
[18]
Yamada A, Komaki Y, Patel N, et al. Risk of postoperative complications among inflammatory bowel disease patients treated preoperatively with vedolizumab. Am J Gastroenterol 2017; 112(9): 1423-9.
[19]
Koh S, Zaghiyan K, Fleshner P. Safety and efficacy of the perioperative use of vedolizumab in medically refractory IBD patients. Does "gut-specificity" impact surgical morbidity? American Society of Cataract and Refractive Surgery/American Society of Ophthalmic Administrators (ASCRS/ASOA) annual meeting; April 30-May 4, 2016. Los Angeles, CA
[20]
Schils N, De Buck van Overstraeten A, Vermeire S, et al. Perioperative use of vedolizumab seems not associated with short-term postoperative infectious complications in patients with Crohn’s disease undergoing right hemicolectomy with ileocolonic anastomosis. 12th Congress of European Crohn’s and Colitis Organizationi (ECCO). February 15-18, 2017; Barcelona, Spain.
[21]
Lightner AL, McKenna NP, Tse CS, et al. Postoperative outcomes in vedolizumab-treated Crohn’s disease patients undergoing major abdominal operations. Aliment Pharmacol Ther 2018; 47: 573-80.
[22]
Ferrante M, de Buck van Overstraeten A, Schils N, et al. Perioperative use of vedolizumab is not associated with postoperative infectious complications in patients with ulcerative colitis undergoing colectomy. J Crohn’s Colitis 2017; 11(11): 1353-61.
[23]
Lightner AL, McKenna NP, Moncrief S, et al. Surgical outcomes in vedolizumab-treated patients with ulcerative colitis. Inflamm Bowel Dis 2017; 23(12): 2197-201.
[24]
Kiely JM, Fazio VW, Remzi FH, Shen B, Kiran RP. Pelvic sepsis after IPAA adversely affects function of the pouch and quality of life. Dis Colon Rectum 2012; 55(4): 387-92.
[25]
Papamichael K, Chachu KA, Vajravelu RK, et al. Improved long-term outcomes of patients with inflammatory bowel disease receiving proactive compared with reactive monitoring of serum concentrations of infliximab. Clin Gastroenterol Hepatol 2017; 15(10) 1580-8 e3
[26]
Ungar B, Levy I, Yavne Y, et al. Optimizing anti-tnf-alpha therapy: serum levels of infliximab and adalimumab are associated with mucosal healing in patients with inflammatory bowel diseases. Clin Gastroenterol Hepatol 2016; 14(4) 550-7 e2.
[27]
Ungar B, Kopylov U, Yavzori M, et al. Association of vedolizumab level, anti-drug antibodies, and alpha4beta7 occupancy with response in patients with inflammatory bowel diseases. Clin Gastroenterol Hepatol 2018; 16(5): 697-705. e7
[28]
Yacoub W, Williet N, Pouillon L, et al. Early vedolizumab trough levels predict mucosal healing in inflammatory bowel disease: a multicentre prospective observational study. Aliment Pharmacol Ther 2018; 47(7): 906-12.
[29]
Dreesen E, Verstockt B, Bian S, et al. Evidence to support monitoring of vedolizumab trough concentrations in patients with inflammatory bowel diseases. Clin Gastroenterol Hepatol 2018; 16(12): 1937-46. e8
[30]
Al Bawardy B, Piovezani Ramos G, Willrich MAV, et al. Clinical experience with vedolizumab trough levels in inflammatory bowel disease. Gastroenterol 2018; 154(6): S821-22.
[31]
Rosario M, Wyant T, Leach T, et al. Vedolizumab pharmacokinetics, pharmacodynamics, safety, and tolerability following administration of a single, ascending, intravenous dose to healthy volunteers. Clin Drug Investig 2016; 36(11): 913-23.
[32]
Lau C, Dubinsky M, Melmed G, et al. The impact of preoperative serum anti-TNFalpha therapy levels on early postoperative outcomes in inflammatory bowel disease surgery. Ann Surg 2015; 261(3): 487-96.
[33]
Zimmerman LA, Zalieckas JM, Shamberger RC, Bousvaros A. Postoperative complications of pediatric patients with inflammatory bowel disease treated with vedolizumab. J Pediatr Surg 2018; 53(7): 1330-3.
[34]
Lightner AL, Tse CS, Potter DD Jr, Moir C. Postoperative outcomes in vedolizumab-treated pediatric patients undergoing abdominal operations for inflammatory bowel disease. J Pediatr Surg 2018; 53(9): 1706-9.
[35]
Schleier L, Wiendl M, Binder M-T, et al. α4ß7 integrin-dependent gut homing of non-classical monocytes is essential for intestinal wound healing mediated by M2 mamcrophages. 13th Congress of european crohn's and colitis organization Vienna, Austria. 2018 14-7.

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