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Fistulae development is a common complication of Crohn's disease (CD) and is often refractory to treatment.

In the randomized, double-blind, phase IV ENTERPRISE study, recently published online in, Schwartz et al. evaluated two intravenous dosing regimens of the monoclonal antibody vedolizumab (Entyvio) in patients with moderate-to-severe perianal fistulizing CD. They found that intravenous vedolizumab led to reductions in draining fistulae and sustained fistula closure in CD patients after 30 weeks. Clinically relevant improvement was observed as early as 2 weeks and maintained through week 30, regardless of dosing regimen. One limitation to the study was the lack of a placebo group, which precluded the estimation of the fistulae closure rate.

Overall, this study suggests that intravenous vedolizumab is effective in patients with fistulizing CD, and I believe this treatment strategy could be implemented in the clinic.

Melinda Engevik, PhD, is an assistant professor at Medical University of South Carolina in Charleston.

You can read an interview with two of the study authors here, and the abstract of the study here.