ArticleFrontiers in medicine2025
Efficacy of vedolizumab as maintenance therapy in a patient with ulcerative colitis on hemodialysis for end-stage renal failure: a case report.
Article in Frontiers in medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Hemodialysis is an important life-sustaining treatment for patients with end-stage renal failure (ESRF), but its ultrafiltration process may induce hypoalbuminemia and compromise systemic immune competence. In Ulcerative colitis (UC), immune dysregulation underlies chronic inflammation. Vedolizumab (VDZ), a humanized monoclonal antibody selectively targeting the α4β7 integrin expressed on gut-homing lymphocytes, demonstrates efficacy in moderate-to-severe UC. However, its pharmacokinetic profile in hemodialysis-dependent patients remains poorly defined due to limited data in this population. Case presentation: A 50-year-old male with ESRF secondary to renal allograft failure (2012) received maintenance thrice-weekly hemodialysis. In February 2022, he developed mucoid and bloody purulent stools and was diagnosed with UC. Initial therapy with oral mesalazine (4 g daily) failed to control symptoms, resulting in clinical deterioration. Subsequently, VDZ was initiated at a standard induction regimen: 300 mg intravenous infusions at weeks 0, 2, 6, followed by maintenance dosing every 8 weeks. Intervention and outcome: Clinical remission with complete mucosal healing (Mayo endoscopic score 0) was achieved by week 22. Post-dialysis trough serum VDZ concentration measured 13.35 μg/mL, with no detectable anti-drug antibodies. Renal function remained stable throughout (estimated glomerular filtration rate [eGFR] 3.45 mL/min/1.73m
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