The Crohn’s Disease-Ulcerative Colitis Clinical AppraisalPart II – Emerging trends in clinical practice

The Crohn’s Disease-Ulcerative Colitis Clinical Appraisal
Part II – Emerging trends in clinical practice

Statement 1: Non-selective anti-integrin therapy with natalizumab or selective anti-integrin therapy with vedolizumab has a steroid-sparing effect in patients with Crohn’s disease.

William J. Sandborn, MD

Academic Content

Publication Overview Introduction Navigating this Publication See Part I

Rationale and Definition

International Clinician Survey Results

Data Review and Faculty Summary

International and Faculty Survey Comparison and Faculty Discussion

Dr. Sandborn’s Observed Future Directions and References

Faculty Presentations

Statement 1 Statement 2 Statements
3a and 3b Statement 4 Statement 5 Statement 6 Statement 7 Statement 8

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Clinical Gastroentrology and Hepatology

See Statements:

1

2

3

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5

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8

Statement 1 Steps:

1 2 3 4 5

Reader: Please indicate your degree of support for Statement 1 on the following scale:

Agree completely
Agree with minor reservations
Agree with major reservations
Reject with reservations
Reject completely

Statement Rationale and Definition

Steroids are effective as induction agents in patients with Crohn’s disease (CD).¹ Approximately 50% of patients who initially respond to steroids will relapse during steroid tapering or within 1 year following steroid induction therapy and will require additional steroid therapy.^1,2 These patients are deemed to be steroid-dependent.¹ Steroid-sparing therapies for such patients include the immunosuppressive agents azathioprine (AZA), 6-mercaptopurine (MP), and methotrexate (MTX),² as well as the tumor necrosis factor-α (TNF) antagonists infliximab (IFX) and adalimumab (ADA).¹ These therapies are not always effective for steroid-sparing, however,³ and additional steroid-sparing therapies are needed. Integrin antagonists are relatively new treatments and emerging evidence supports their efficacy as steroid-sparing treatment options.