Vedolizumab for the Treatment of Noninflammatory Bowel Disease Related Enteropathy

Vedolizumab has become an integral part of the therapeutic armamentarium for patients with inflammatory bowel disease (IBD) who have failed conventional medical therapy. Vedolizumab is an α4β7 integrin antagonist that inhibits intestinal T-cell translocation by blocking integrin interactions with mucosal vascular addressin cellular adhesion molecule 1, reducing lymphocyte-mediated inflammation.¹ Its gut selective mode of action and favorable safety profile have led to reports of off-label use for non-IBD-related inflammatory intestinal disorders, such as microscopic colitis,² and small intestinal inflammatory conditions including autoimmune enteropathy³ and common variable immune deficiency-related enteritis.⁴ Treatment of non-IBD-related enteropathies is challenging with no approved therapies or established treatment algorithms. We conducted a literature review to assess clinical, endoscopic, and histologic improvement in patients treated with vedolizumab for non-IBD enteropathies refractory to conventional therapy.