Discussion

The evidence demonstrates that both non-selective integrin antagonism with the α₄ antibody natalizumab and selective integrin antagonism with the α₄β₇ antibody vedolizumab have efficacy for steroid sparing in patients with moderately to severely active CD who are receiving steroids and who have responded to induction therapy with an integrin antagonist.^5,8 The majority of the Clinical Appraisal faculty (88%) agreed completely with this statement, and the rest agreed with minor reservations. In contrast, among practitioners surveyed internationally, only 30% completely agreed with the statement, 49% agreed with minor reservations, 17% agreed with major reservations, and 4% rejected the statement with reservations. These differences demonstrate an important gap in knowledge and a need for further education on this topic.