Early changes in the pharmacokinetic profile of vedolizumab-treated patients with IBD may predict response after dose optimisation

We read with interest the recent paper by Colombel et al1 showing that vedolizumab is frequently used for patients with inflammatory bowel disease (IBD). There is evidence for an exposure–efficacy relationship for vedolizumab induction therapy.2 Increasing dosing frequency of vedolizumab to every 4 weeks leads to an improvement in clinical response in both ulcerative colitis (UC)3 and Crohn's disease (CD).4 In contrast to anti-tumour necrosis factor (TNF) agents, the correlation between the response to dose optimisation and changes in the pharmacokinetic profile of vedolizumab-treated patients remains unknown. We performed a retrospective analysis of all vedolizumab-treated patients that increased dosing frequency because of primary non-response (≤week 14 after treatment initiation) or secondary loss of response (>week 14 after treatment initiation) in our tertiary referral IBD centre (Nancy University Hospital) between 1 April 2016 and 31 May 2017. Treatment response, defined as an improvement in clinical...

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