Cutaneous Manifestations of IBD: Potential Role of Vedolizumab
Abstract
Knowledge of the pathophysiology of immune-mediated diseases continues to advance. In the past decade there has been a rapid evolution of immune-targeted therapies that have grown in precision. Overlapping immune abnormalities results in overlapping diseases, co-morbidities, and treatments. Dermatologists, gastroenterologists, rheumatologists, respirologists, allergists, and oncologists now share and co-manage more patients who often have more complex issues. Understanding how our therapies impact these immunologically related and often comorbid conditions is necessary to provide comprehensive care. Frequently, the dermatologist makes therapeutic decisions that have a positive impact on numerous comorbidities without exacerbating other conditions. This is especially prevalent in some parts of the country that have long wait times to receive care and a dearth of specialists. Of interest is the idea that as our therapies become even more precise and disease specific, they may no longer have an overlapping therapeutic effect on common comorbidities. For instance, the evolving landscape of inflammatory bowel disease (IBD) treatments, and the increased use and development of gut-specific therapies introduces the question of whether these treatments will have any impact on the incidence and management of extraintestinal manifestations (EIMs) of IBD. The intent of this article is to review the more common and important EIMs of IBD and to explore the available evidence on the impact of vedolizumab, which is a gut-specific medication, on these EIMs.
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