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
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2
Q

indications

A

under expert supervision: Crohn’s disease and UC

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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
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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

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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
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6
Q

Conception and contraception

A

effective contraception required during and for at least 18 weeks after treatment

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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
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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
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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
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