From the Guidelines
Entyvio (vedolizumab) typically takes 6-14 weeks to show clinical improvement in severe and acute ulcerative colitis (UC) flares, which is slower than some other biologics. For patients with severe UC flares, physicians often use bridge therapy with corticosteroids (such as prednisone 40-60 mg daily, tapered over 8-12 weeks) while waiting for Entyvio to take effect 1. The standard Entyvio dosing regimen is 300 mg IV infusions at weeks 0,2, and 6, followed by maintenance dosing every 8 weeks. Some patients may respond faster, within 4-6 weeks, but many require the full induction period or longer. Entyvio works by selectively blocking α4β7 integrin, preventing inflammatory cells from migrating into the gut tissue, which explains its gut-selective mechanism and relatively slower onset compared to TNF inhibitors 1.
Key points to consider when using Entyvio for severe and acute UC flares include:
- The importance of bridge therapy with corticosteroids to manage symptoms while waiting for Entyvio to take effect 1
- The standard dosing regimen and potential need for adjustments based on patient response 1
- The relatively slower onset of action compared to other biologics, such as TNF inhibitors 1
- The potential need for hospitalization and consideration of rescue therapy or colectomy for patients with severe flares not responding to treatment 1
It is essential to weigh the benefits and risks of Entyvio treatment, considering the potential for improved clinical outcomes and the risk of adverse events, such as infections and infusion reactions 1. By prioritizing the most recent and highest-quality evidence, clinicians can make informed decisions about the use of Entyvio in patients with severe and acute UC flares.
From the Research
Entyvio Acting Time in Severe and Acute UC Flare
- The exact acting time of Entyvio (vedolizumab) in severe and acute ulcerative colitis (UC) flare is not explicitly stated in the provided studies 2, 3, 4, 5, 6.
- However, according to the study by 2, patients with ulcerative colitis had significantly higher rates of clinical response and clinical remission when treated with vedolizumab than when receiving placebo at both 6 and 52 weeks.
- Another study by 5 compared vedolizumab with adalimumab in adults with moderately to severely active ulcerative colitis and found that clinical remission was observed in a higher percentage of patients in the vedolizumab group than in the adalimumab group at week 52.
- The study by 4 discussed the optimal strategies for drug therapy in acute severe ulcerative colitis, but did not provide specific information on the acting time of Entyvio.
- A study by 6 assessed the efficacy of biologic and small molecule agents as second-line therapy after exposure to TNF inhibitors in patients with ulcerative colitis, but did not provide information on the acting time of Entyvio in severe and acute UC flare.
Key Findings
- Vedolizumab is effective in treating moderately to severely active ulcerative colitis 2, 5.
- The efficacy of vedolizumab is comparable to or superior to other biologic agents in some studies 5, 6.
- However, there is limited information available on the exact acting time of Entyvio in severe and acute UC flare.
Treatment of Acute Severe Ulcerative Colitis
- According to the study by 3, intravenous corticosteroids are the first-line treatment for acute severe ulcerative colitis.
- Rescue treatment with ciclosporin or infliximab is indicated in patients who do not sufficiently respond to corticosteroids after 3-5 days 3.
- The study by 4 discussed the importance of timely decision-making with rescue therapy or surgical treatment in managing acute severe ulcerative colitis.