Vedolizumab for the Treatment of Pyoderma Gangrenosum in a C
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Vedolizumab is a humanized monoclonal integrin blocker with gut selective effects on lymphocyte trafficking.

A 38-year-old Caucasian woman with complex fistulizing CD, status post subtotal colectomy with ileostomy and complicated by peristomal, facial, and leg PG, presented to IBD clinic with worsening abdominal cramping and increased ostomy output.

On arrival, she was vitally stable. Her most recent labwork was significant for an erythrocyte sedimentation rate of 44 (normal: 0-22), C-reactive protein of 8.48 (average: 1.0-3.0), and fecal calprotectin of less than 15.6 (normal: less than 50.0).

She was started on VDZ induction therapy: 300 mg IV at weeks 0, 2, 6, and 14. After two doses, her leg PG was noted to be nearly healed.

Additionally, her abdominal cramping and ostomy output improved, and she was able to taper from 40 mg daily prednisone to 20 mg. After her fourth induction dose, her peristomal, facial, and leg PG were all inactive.

She was started on VDZ maintenance infusions: 300 mg IV every eight weeks. At her three months follow-up, she was down to 5 mg of prednisone daily.

Healed leg and abdominal pyoderma gangrenosum after taking vedolizumab for approximately one year.

Three years later, her PG remains inactive on VDZ maintenance infusions and off chronic prednisone.

Source: https://www.cureus.com/articles/48844-vedolizumab-entyvio-for-the-treatment-of-pyoderma-gangrenosum-in-a-crohns-disease-patient
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