Successful treatment with vedolizumab in an adolescent with Crohn disease who had developed active pulmonary tuberculosis while receiving infliximab
Open Access
- 31 July 2021
- journal article
- Published by Yeungnam University College of Medicine in Journal of Yeungnam Medical Science
- Vol. 38 (3), 251-257
- https://doi.org/10.12701/yujm.2020.00878
Abstract
Vedolizumab (VDZ) has been approved for the treatment of inflammatory bowel diseases (IBDs) in patients aged ≥18 years. We report a case of a pediatric patient with Crohn disease (CD) who was successfully treated with VDZ. A 16-year-old female developed severe active pulmonary tuberculosis (TB) during treatment with infliximab (IFX). IFX was stopped, and TB treatment was started. After a 6-month regimen of standard TB medication, her pulmonary TB was cured; however, gastrointestinal symptoms developed. Due to the concern of the patient and parents regarding TB reactivation on restarting treatment with IFX, VDZ was started off-label. After the second dose of VDZ, the patient was in clinical remission and her remission was continuously sustained. Ileocolonoscopy at 1-year after VDZ initiation revealed endoscopic healing. Therapeutic drug monitoring conducted during VDZ treatment showed negative antibodies to VDZ. No serious adverse events occurred during the VDZ treatment. This is the first case report in Korea demonstrating the safe and effective use of VDZ treatment in a pediatric CD patient. In cases that require recommencement of treatment with biologics after recovery of active pulmonary TB caused by anti-tumor necrosis factor agents, VDZ may be a good option even in pediatric IBD.Keywords
Funding Information
- National Research Foundation of Korea (2017R1C1B5076980)
- Ministry of Science and ICT
This publication has 20 references indexed in Scilit:
- The Medical Management of Paediatric Crohn’s Disease: an ECCO-ESPGHAN Guideline UpdateJournal of Crohn's and Colitis, 2020
- Management of Paediatric Ulcerative Colitis, Part 1Journal of Pediatric Gastroenterology and Nutrition, 2018
- Early Biologic Treatment in Pediatric Crohn's Disease: Catching the Therapeutic Window of Opportunity in Early Disease by Treat-to-TargetPediatric Gastroenterology, Hepatology & Nutrition, 2018
- Asian Organization for Crohn's and Colitis and Asia Pacific Association of Gastroenterology consensus on tuberculosis infection in patients with inflammatory bowel disease receiving anti-tumor necrosis factor treatment. Part 1: risk assessmentIntestinal Research, 2018
- Asian Organization for Crohn's and Colitis and Asia Pacific Association of Gastroenterology consensus on tuberculosis infection in patients with inflammatory bowel disease receiving anti-tumor necrosis factor treatment. Part 2: managementIntestinal Research, 2018
- Mucosal Healing in Paediatric Patients with Moderate-to-Severe Luminal Crohn’s Disease Under Combined Immunosuppression: Escalation versus Early TreatmentJournal of Crohn's and Colitis, 2016
- Inflammatory Bowel Disease in Children and AdolescentsJAMA Pediatrics, 2015
- Vedolizumab as Induction and Maintenance Therapy for Crohn's DiseaseThe New England Journal of Medicine, 2013
- Vedolizumab as Induction and Maintenance Therapy for Ulcerative ColitisThe New England Journal of Medicine, 2013
- The Binding Specificity and Selective Antagonism of Vedolizumab, an Anti-α4β7Integrin Therapeutic Antibody in Development for Inflammatory Bowel DiseasesThe Journal of pharmacology and experimental therapeutics, 2009