Entyvio (vedolizumab) works by targeting α4β7 integrin, a protein that plays a role in gut inflammation. It blocks the interaction between α4β7 integrin and mucosal addressin cell adhesion molecule-1 (MAdCAM-1), preventing immune cells (T-lymphocytes) from migrating into the gastrointestinal tract.

This mechanism helps reduce inflammation associated with ulcerative colitis (UC) and Crohn’s disease, leading to symptom relief.

Is Entyvio a Biologic?

Yes, Entyvio (vedolizumab) is a biologic medication. It is a monoclonal antibody that belongs to the drug class called integrin receptor antagonists, which specifically target immune system activity in the gut.

What is Entyvio Used For?

Entyvio is an injection that is FDA approved to treat moderate-to-severe ulcerative colitis and Crohn’s disease in adults. It was initially approved in May 2014 to treat these conditions as an intravenous infusion, and later approved as a subcutaneous (under the skin) injection.

Entyvio often serves as a second-line biologic for patients who:

• Have inadequate response to TNF-alpha inhibitors
• Experience TNF-alpha inhibitor side effects
• Require gut-selective therapy due to infection concerns
• Need maintenance therapy with reduced systemic exposure

How Entyvio Works: Detailed Step-by-Step Mechanism

Entyvio (vedolizumab) works through a precise, multi-step process that selectively targets gut inflammation:

Step 1: Inflammatory Cell Activation

When inflammatory bowel disease occurs, immune cells called T lymphocytes become activated in response to perceived threats in the intestinal environment. These activated cells prepare to migrate from the bloodstream into gut tissue.

Step 2: Integrin Expression

Activated T lymphocytes express α4β7 integrin receptors on their surface. These integrins act like molecular "keys" that allow cells to bind to specific tissues.

Step 3: Endothelial Binding

Under normal inflammatory conditions, α4β7 integrins bind to MAdCAM-1 (mucosal addressin cell adhesion molecule-1) proteins displayed on the inner walls of gut blood vessels.

Step 4: Vedolizumab Intervention

Entyvio's humanized monoclonal antibodies specifically bind to the α4β7 integrin receptors, physically blocking their ability to interact with MAdCAM-1.

Step 5: Migration Prevention

Without successful integrin-MAdCAM-1 binding, inflammatory T lymphocytes cannot adhere to gut vessel walls or transmigrate into intestinal tissue, effectively breaking the inflammatory cascade.

Related questions

• How much does Entyvio cost per month?
• Is Entyvio an immunosuppressant or a biologic?
• How long does it take Entyvio to start working?

Step 6: Selective Action

This mechanism is gut-selective because MAdCAM-1 is primarily expressed in gastrointestinal tissues, unlike other adhesion molecules found throughout the body.

Think of Entyvio as a targeted "roadblock" that prevents inflammatory cells from entering your intestines while leaving the rest of your immune system functioning normally.

Entyvio vs. Other IBD Biologics: Mechanism Comparison

Different biologics work in different ways for IBD.

Biologic	Mechanism Target	Selectivity	Primary Action
Entyvio (vedolizumab)	α4β7 integrin	Gut-selective	Blocks lymphocyte migration to GI tract
Remicade (infliximab)	TNF-alpha	Systemic	Neutralizes inflammatory cytokine
Humira (adalimumab)	TNF-alpha	Systemic	Neutralizes inflammatory cytokine
Tysabri (natalizumab)	α4β1 integrin	Systemic	Blocks lymphocyte migration broadly

Entyvio Administration

Entyvio is given as an intravenous infusion or subcutaneous injection. The typical dosing is outlined below.

Infusion Protocol Details

Initial Dosing Schedule:

• Week 0: 300 mg IV infusion (30 minutes)
• Week 2: 300 mg IV infusion (30 minutes)
• Week 6: 300 mg IV infusion (30 minutes)

Maintenance Dosing:

• Every 8 weeks: 300 mg IV infusion (30 minutes)

Subcutaneous Option

After the first two doses of intravenous Entyvio, patients may switch to the subcutaneous (under the skin) injection form after proper training.

• 108 mg subcutaneous injection every 2 weeks

Who Manufactures Entyvio?

Entyvio is manufactured by Takeda Pharmaceuticals, based in Cambridge, MA. You can contact them at 1-877-825-3327.

This is not all the information you need to know about Entyvio (vedolizumab) for safe and effective use and does not take the place of your doctor’s directions. Review the full product information and discuss this information and any questions you have with your doctor or other health care provider.

References

1. Drugs.com. n.d. Entyvio FDA Approval History. Accessed September 27, 2024 at https://www.drugs.com/history/entyvio.html
2. Entyvio [package insert]. Updated June 2024. Takeda Pharmaceuticals America, Inc. Accessed September 27, 2024 at https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=6e94621c-1a95-4af9-98d1-52b9e6f1949c
3. Hu, Z., et. al. 2024. Selection strategy of second-line biologic therapies in adult patients with ulcerative colitis following prior biologic treatment failure: Systematic review and meta-analysis. In: Pharmacological Research. DOI: https://doi.org/10.1016/j.phrs.2024.107108

Read next

See also:

Related medical questions

• Does Entyvio increase the risk of cancer?
• Does Entyvio cause weight gain?
• Entyvio and the COVID vaccine, what should I know?
• Does Entyvio cause joint pain?
• Can Entyvio cause hair loss?
• Will I lose weight with Entyvio?
• How long has Entyvio been on the market?
• How long does an Entyvio infusion take?
• Does Medicaid cover Entyvio?
• Can Entyvio be given at home?
• How is Entyvio administered?
• How effective is Entyvio for Crohn’s Disease?
• How effective is Entyvio for Ulcerative Colitis?
• How does Entyvio copay assistance work?

Drug information

• Entyvio Information for Consumers
• Entyvio prescribing info & package insert (for Health Professionals)
• Side Effects of Entyvio (detailed)
• Entyvio user reviews (168)

Related support groups

• Entyvio (25 questions, 34 members)
• Ulcerative Colitis (79 questions, 188 members)
• Crohn's Disease (65 questions, 286 members)

Medical Disclaimer