Abstract
Vedolizumab is a monoclonal antibody that binds to the gut-specific α4β7 integrin on lymphocytes and prevents lymphocytes entering gut tissues. This gut-selective immunosuppression has been shown to be effective in treatment of active Crohn's disease and ulcerative colitis and to maintain clinical response and remission in patients who neither conventional therapy nor tumour necrosis factor (TNF) inhibitor therapy have helped. It is slow in onset of action, but the gut-selectivity offers the prospect of a safe alternative to systemically active drugs. It is effective in pouchitis, perianal Crohn's disease and children with inflammatory bowel disease. Its different mode of action to anti-TNF therapies makes it an important alternative.
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