Vedolizumab-related arthralgias in patients with inflammatory bowel
disease: A systematic review
Abstract
Aim: Multiple papers have reported the development of new-onset
arthralgias with vedolizumab (VDZ) for the treatment of inflammatory
bowel disease (IBD). Other studies have shown that VDZ may help in
preexisting enteropathic spondyloarthropathy. We sought to probe this
issue by conducting a systematic review. Methods: Embase, Medline,
Cochrane Central, and Web of Science were searched up to June 29, 2020
for randomized controlled trials evaluating vedolizumab treatment in
patients with IBD in which development of arthralgias was noted. Risk of
bias and quality were assessed using Cochrane’s collaboration tool and
the GRADE system, respectively. PROSPERO registration number:
CRD42020197101. Results: Four hundred sixty-one discrete articles were
retrieved. Five studies (n=2,899) met inclusion criteria. Comparing the
risk of arthralgia in patients treated with VDZ and placebo yielded odds
ratio’s which ranged between 1.01 (95% confidence interval (CI)
0.61-1.65) and 10.20 (95% CI: 0.53-195.78). While each study noted an
increased incidence of arthralgias in patients receiving VDZ, none
proved statistically significant. Studies were heterogeneous in disease
populations, VDZ dosage, time-points for evaluation, and data points
collected. Post-hoc analyses suggested an increased risk of arthralgias
in patients with prior TNF inhibitor use. Conclusion: The included
studies showed a trend toward increased arthralgias in patients with IBD
who received VDZ. However, our study lacked any statistically
significant findings to identify a clear link. More research is needed
to substratify which patients develop arthralgias when treated with VDZ
in order to better understand whether heightened risk can be predicted
prior to treatment initiation.