vedolizumab Flashcards
1
Q
MOA
A
- immunosupressant anti-lymphocyte max
- binds specifically to a4b7 integral which is expressed in the gut and homes T helper cells and causes reduction in GI inflammation
2
Q
indications
A
under expert supervision: Crohn’s disease and UC
3
Q
cautions
A
- Controlled chronic severe infection
- History of recurring severe infection
- Previous treatment with rituximab
- Previous treatment with natalizumab (wait at least 12 weeks between use unless potential benefit outweighs risk)
- Risk of infection
– Patients must be screened for TB before starting
– If latent TB is diagnosed, appropriate treatment must be initiated prior to treatment
– If TB diagnosed during treatment, discontinue until infection resolved
4
Q
pre-screening needed before initiation
A
○ Patients must be screened for TB before starting
○ If latent TB is diagnosed, appropriate treatment must be initiated prior to treatment
○ If TB diagnosed during treatment, discontinue until infection resolved
5
Q
interactions
A
- Live vaccines predicted to increase risk of generalised infection, possibly life threatening
- avoid!!
- e.g. cholera, dengue, influenza, MMR, rotavirus, typhoid, varicella-zoster, yellow fever, Bacillus Calmette-Gurein
6
Q
Conception and contraception
A
effective contraception required during and for at least 18 weeks after treatment
7
Q
monitoring requirements
A
- Monitor closely for infection before, during and after treatment - potential increased risk for opportunistic infection
- Monitor for new onset or worsening neurological signs and symptoms (withhold treatment if progressive multifocal leukoencephalopathy (PML) suspected)
- signs of PML include: Loss of coordination and weakness, loss of language, visual problems, headaches
8
Q
SE
A
- arthralgia
- constipation, GI discomfort, GI disorders
- headache, fatigue, fever
- increased risk of infection
- cough, nasal congestion
- hypertension
- muscle spasms, muscle weakness
- oropharyngeal pain, pain, paraesthesia
- skin reactions
9
Q
infusion related and hypersensitivity reactions have been reported
A
- pt need to be observed continuously during each infusion for signs and symptoms of acute hypersensitivity reactions
- observe pt 2 hours after initial to infusions, and for 1 hour after subsequent infusions
- discontinue if severe infusion related or other severe reaction occurs and initiate appropriate treatment (e.g. adrenaline and antihistamine)
- if mild to moderate infusion related reaction, interrupt infusion or reduce infusion rate and initiate appropriate treatment ; if reaction subsides infusion may be continued
- consider pretreatment with an antihistamine, HC, and/or paracetamol prior to subsequent infusions in pt with mild to moderate infusion related reactions