Identification of biomarkers to predict response to Vedolizumab in Inflammatory Bowel Disease

Inflammatory bowel disease causes inflammation of the intestine which can result in significant symptoms and negatively impact on quality of life. 

Patients and doctors now have an increasing choice of medications to treat the two main forms of inflammatory bowel disease, ulcerative colitis and Crohn’s disease.  One of the newest is a biological antibody treatment called vedolizumab, which stops inflammatory cells reaching the intestine and causing inflammation.  However, while it works very effectively in some patients, not all who receive vedolizumab get better.  At the moment we are unable to accurately predict which patients will benefit from the drug.  This can result in patients receiving an ineffective treatment with a “trial and error” approach taken to treatment choice.  Further, this drug is expensive, and prescribing it only to those patients who will benefit will lead to important cost savings; this is a vital consideration at a time when the NHS is under considerable financial pressure. 

The aim of this study is to develop a blood test that can be performed before starting treatment, that will help predict treatment response and allow us to determine if vedolizumab is the best choice for each individual patient.  The study will test the DNA of two groups of patients whose inflammatory bowel disease either got better, or did not get better, with vedolizumab. 

The study will assess if mutations in the DNA sequence (gene mutations), or the way the DNA is read by the body (epigenetic mutations), to make proteins important for the way vedolizumab works are different between these two groups.  These tests are known as “biomarkers” and are a key part of personalised medicine that aims to improve the care of patients with many medical conditions including inflammatory bowel disease.