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Response to: ‘Simultaneous inhibition of α4/β7 integrin and tumor necrosis factor-α in concomitant spondyloarthritis and inflammatory bowel disease’ by Richard et al
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  1. Gaëlle Varkas1,2,
  2. Dirk Elewaut1,2
  1. 1 Department of Rheumatology, Ghent University Hospital, Ghent, Belgium
  2. 2 VIB Inflammation Research Center, Ghent University, Ghent, Belgium
  1. Correspondence to Dr Dirk Elewaut, Department of Rheumatology, University Hospital of Ghent, Ghent, 9000, Belgium; dirk.elewaut{at}ugent.be

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We thank Dr Richard et al for their interest in our work and the communication of their experiences in daily practice.1 In patients affected with both spondyloarthritis (SpA) and refractory inflammatory bowel disease (IBD) despite anti-tumour necrosis factor (TNF) therapy, treatment options are limited. While anti-TNF therapy has shown remarkable efficacy in the treatment of both axial and peripheral SpA, even long term, the results in IBD were less satisfying.2 3 With the introduction of vedolizumab, a new mode of action and hope for refractory patients was installed.4 5 Nevertheless, as we reported earlier, vedolizumab did not show any efficacy in a series of patients with SpA  and might even induce SpA-like disease in certain individuals.6 …

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