We read with interest the article by Varkas et al 1 suggesting a temporal association between the initiation of vedolizumab (VDZ) for inflammatory bowel disease (IBD) and induction or worsening of spondyloarthritis (SpA). This suggests that in patients with IBD, there may be limited efficacy of α4/β7 integrin blockade for management of extraintestinal manifestations, particularly for arthritis and sacroiliitis.2 3 Treatment of SpA in subjects on VDZ for associated IBD is highly challenging for the treating physician. We describe below two patients who were treated with a combination treatment of VDZ and certolizumab pegol …

中文翻译：

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同时抑制 α4/β7 整合素和肿瘤坏死因子-α 在并发脊柱关节炎和炎症性肠病中的作用

我们饶有兴趣地阅读了 Varkas 等人 1 的文章，该文章表明维多珠单抗 (VDZ) 治疗炎症性肠病 (IBD) 与诱发或加重脊椎关节炎 (SpA) 之间存在时间关联。这表明，在 IBD 患者中，α4/β7 整联蛋白阻断剂用于治疗肠外表现的疗效可能有限，特别是对于关节炎和骶髂关节炎。2 3 VDZ 患者的 SpA 治疗相关 IBD 对治疗医生来说极具挑战性. 我们在下面描述了接受 VDZ 和 certolizumab pegol 联合治疗的两名患者……