Vedolizumab cascade

IBD

Vedolizumab intraveneus

Inductie: week 2 dalspiegel > 30 ug/ml week 6 dalspiegel > 20 ug/ml

Onderhoud: dalspiegel > 12 ug/ml

Vedolizuman subcutaan week 12: dalspiegel > 31 ug/ml week 24: dalspiegel > 37 ug/ml

Antistoffen < 12 AE/ml: niet aantoonbaar Antistoffen > 12 AE/ml: aantoonbaar

Dit betreft een cascade aanvraag. De concentratie vedolizumab wordt bepaald. Indien de vedolizumab concentratie onder de bepalingsgrens ligt worden tevens vedolizumab antistoffen bepaald. Indien de vedolizumab concentratie meetbaar is worden er geen vedolizumab antistoffen bepaald. Vedolizumab concentratie en vedolizumab antistoffen zijn niet meer los aan te vragen.

Over het algemeen wordt er weinig immunogeniciteit gezien bij gebruik van vedolizumab (<5%).

Bepaling valt onder de ISO15189 scope van verzendlaboratorium M005.

1. Yacoub et al. Early vedolizumab through levels predict mucosal healing in IBD: a multicentre prospective observational study. Aliment Pharmacol Ther. 2018; 47(7): 906-12
2. Dreesen et al. Evidence to support monitoring of vedolizumab through concentrations in patients with IBD. Clin Gastroeneterol Hepatol. 2018
3. Ward et al. TDM of vedolizumab in IBD: current data and future prospectives. Therap Adv gastroenterol. 2018
4. Lieven Pouillon, Séverine Vermeire and Peter Bossuyt . Vedolizumab trough level monitoring in inflammatory bowel disease: a state-of-theart overview. BMC Medicine (2019) 17:89
5. Sophie Restellini, Reena Khanna, and Waqqas Afif. Therapeutic Drug Monitoring With Ustekinumab and Vedolizumab in Inflammatory Bowel Disease. Inflamm Bowel Dis. Volume 24, Number 10, October 2018
6. Miles P. Sparrow, Konstantinos Papamichael, Mark G. Ward, Pauline Riviere, David Laharie, Stephane Paul, Xavier Roblin. Therapeutic Drug Monitoring of Biologics During Induction to Prevent Primary Non-Response. Journal of Crohn’s and Colitis, 2020, 543–556
7. Siddharth Singh, Parambir S. Dulai, Niels Vande Casteele, Robert Battat, Mathurin Fumery, Brigid S. Boland, William J. Sandborn. Systematic Review with meta-analysis: association between vedolizumab trough concentration and clinical outcomes in patients with inflammatory bowel diseases. Aliment Pharmacol Ther. 2019 October ; 50(8): 848–857
8. Cao WT, Huang R, Jiang KF, Qiao XH, Wang JJ, Fan YH, Xu Y. Predictive value of blood concentration of biologics on endoscopic inactivity in inflammatory bowel disease: A systematic review. World J Gastroenterol 2021; 27(9): 886-907
9. Volkers et al. Real world experience of switching form intraveneous to subcutaneous vedolizumab maintenance treatment for inflammatory bowel diseases. Aliment Pharmacol Ther. 2022: 56(6): 1044-1054