Anti-cytokine antibodies, such as Infliximab (an anti TNF alfa chimeric antibody) and Adalimumab (an anti TNF alfa humanize antibody), have been developed and used in clinical practice for the treatment of patients with Crohn disease (CD). Unfortunately, their efficacy is limited. Based on these concepts, a new drug has been developed for IBD treatment. Vedolizumab (VDZ) is able to recognize the α4β7 heterodimer, and selectively blocks gut lymphocyte trafficking. The hypothesis of this study is that VDZ therapy may be to halt CD disease progression during time and modifying its natural history, using Lemann Index.
All patients who will enter in the study will be follow-up at weeks 2-6-14-22-30-38-46 or before in case of relapse. A relapse will be defined by an Harvey Bradshaw Index ≥ 5 for 2 consecutive weeks. The following data are to be recorded: 1. Physical examination 2. Adverse Event Review 3. Weight in Kg 4. Full blood count 5. Biochemical series including serum iron, serum ferritin, C reactive protein (PCR), ESR (eritrosedimatation rate) 6. Fecal Calprotectin 7. VDZ fecal loos 8. VDZ trough levels and antidrug antibodies 9. Current treatments The last visit will be performed at week 54. The following data are to be recorded: 1. Physical examination 2. Adverse Event Review 3. Weight in Kg 4. Full blood count 5. Biochemical series including serum iron, serum ferritin, C reactive protein (PCR), ESR (eritrosedimatation rate) 6. Fecal Calprotectin 7. VDZ fecal loos 8. VDZ trough levels and antidrug antibodies 9. Current treatments 10. Routine lower and upper gastrointestinal endoscopy and magnetic resonance imaging or computed tomography of the small bowel 11. SES-CD 12. Lemann Index
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Harvey Bradshaw index
Primary responders will defined as by a decrease of Harvey Bradshaw Index at week 14 of 3 point from the Harvey Bradshaw Index calculate at week 0.
Time frame: Week 0-14
Lèmann Index
Time frame: Week 0 and Week 54
VDZ trough levels
Time frame: Week 0-2-6-14-22-30-38-46-54
anti-drug antibodies
Time frame: Week 0-2-6-14-22-30-38-46-54
fecal VDZ loss
The investigators will evaluated the VDZ quantity (microgram) that a patients with mucosal ulcers could loss in patients feces.
Time frame: Week 0-2-6-14-22-30-38-46-54
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