Vedolizumab is recommended as an option for treating moderately to severely active Crohn's disease only if:
a tumour necrosis factor‑alpha inhibitor has failed (that is, the disease has responded inadequately or has lost response to treatment) or
a tumour necrosis factor‑alpha inhibitor cannot be tolerated or is contraindicated.
Vedolizumab is recommended only if the company provides it with the discount agreed in the patient access scheme.
Vedolizumab should be given as a planned course of treatment until it stops working or surgery is needed, or until 12 months after the start of treatment, whichever is shorter. At 12 months, people should be reassessed to determine whether treatment should continue. Treatment should only continue if there is clear evidence of ongoing clinical benefit. For people in complete remission at 12 months, consider stopping vedolizumab, resuming treatment if there is a relapse. People who continue vedolizumab should be reassessed at least every 12 months to decide whether continued treatment is justified.
People whose treatment with vedolizumab is not recommended in this NICE guidance, but was started within the NHS before this guidance was published, should be able to continue treatment until they and their NHS clinician consider it appropriate to stop.