From the Research
The dose of vedolizumab for collagenous gastritis is not established, but the typical dosing regimen used for inflammatory bowel disease can be followed: 300 mg intravenous infusion at weeks 0,2, and 6 for induction, followed by maintenance dosing of 300 mg every 8 weeks, as seen in a case report from 2023 1.
Key Considerations
- The evidence for vedolizumab in collagenous gastritis is limited to case reports and small series, such as the one reported in the ACG case reports journal in 2023 1.
- Vedolizumab works by blocking the α4β7 integrin, preventing lymphocyte trafficking to the gastrointestinal tract and reducing inflammation.
- Treatment duration is individualized based on clinical response, typically assessed after 8-14 weeks of therapy.
- Monitoring should include regular assessment of symptoms, endoscopic evaluation, and histological examination to determine treatment efficacy.
Dosing and Administration
- The typical dosing regimen for inflammatory bowel disease can be used as a guide: 300 mg intravenous infusion at weeks 0,2, and 6 for induction, followed by maintenance dosing of 300 mg every 8 weeks.
- For patients who don't respond adequately, some clinicians consider dose intensification to every 4 weeks during maintenance.
Safety and Efficacy
- Higher vedolizumab serum levels do not increase the risk of adverse events in patients with inflammatory bowel disease, as reported in a study published in the Scandinavian journal of gastroenterology in 2020 2.
- The evidence for vedolizumab in collagenous gastritis is limited, and patients should be aware that response rates vary.
Alternative Treatments
- Conventional treatments like budesonide, proton pump inhibitors, or other immunosuppressants should be considered before using vedolizumab, as reported in a study published in Clinical gastroenterology and hepatology in 2022 3.
- Topical budesonide has been shown to be effective in treating collagenous gastritis, with 89% of patients achieving a clinical response and 88% achieving a histologic response, as reported in a study published in Clinical gastroenterology and hepatology in 2022 3.