Natalizumab for the treatment of Crohn’s disease. Report of three cases

Daniela Fluxá, Patricio Ibáñez, Lilian Flores, Carolina Figueroa, Jaime Lubascher, Udo Kronberg, Daniela Simian, Gonzalo Pizarro, Paola Toche, Rodrigo Quera*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Anti-tumor necrosis factor-α (TNF) agents have dramatically changed the management of Crohn’s Disease (CD). However, a significant number of these patients do not respond at all or cease to respond to antibodies against TNF. In this clinical situation, the options include intensification of anti-TNF therapy by either increasing the dose or by shortening the administration interval, the use of a second anti-TNF or medications with a different mechanism of action. Among the later, Natalizumab, a humanized IgG4 monoclonal antibody against α4β1 and α4β7 integrins, is safe and effective in inducing and maintaining remission in active CD patient’s refractory to anti-TNF. In spite of this, Natalizumab use has been limited because of an increased risk of progressive multifocal leukoencephalophaty which results from reactivation of the John Cunningham (JC) virus. However, the presence of antibodies against JC virus in serum can be used to reduce the risk for this complication. We report three patients with Crohn’s disease refractory to treatment with infliximab, who responded successfully to the use of Natalizumab.

Translated title of the contributionNatalizumab for the treatment of Crohn’s disease. Report of three cases
Original languageSpanish
Pages (from-to)538-543
Number of pages6
JournalRevista Medica de Chile
Volume145
Issue number4
DOIs
StatePublished - Apr 2017
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2017, Sociedad Medica de Santiago. All rights reserved.

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