Efficacy and Safety of Natalizumab in Crohn’s Disease Patients Treated at 6 Boston Academic Hospitals

Abstract

In our clinical experience outside the context of a clinical trial, natalizumab is largely reserved for CD patients with extensive ileocolonic disease who have failed conventional immunosuppressants and of at least 2 anti-tumor necrosis factor agents. This drug is, however, well tolerated and offers significant clinical improvement for more than a year in one-third of these difficult-to-treat CD patients.

Adverse events in IBD: to stop or continue immune suppressant and biologic treatment

“…Adverse effects were reported in 22 of 69 patients treated at Boston area academic centers including infusion reactions, headache, fever and infections. PML was not reported [145]. …”

Experiencia local con natalizumab en pacientes con enfermedad de Crohn refractaria a anti-TNF: Casos clínicos

“…Natalizumab usado como monoterapia en dosis de 300 mg cada 4 semanas ha demostrado ser efectivo y seguro en EC refractaria a agentes anti-TNF [9][10][11][12][13][14][15][16][17] . Además, este fármaco ha demostrado ser eficaz en población pediátrica con EC con tasas de remisión clínica de 50% 18 .…”

“…Natalizumab es un anticuerpo monoclonal IgG4 anti-integrina-α4 humanizado que bloquea la adhesión y migración de leucocitos desde los vasos sanguíneos al tejido inflamado 7,8 . Este fármaco ha mostrado ser efectivo en inducir y mantener la remisión en pacientes con EC [9][10][11][12][13][14][15][16][17][18] . Sin embargo, su uso se ha visto limitado por reportes que han descrito el desarrollo de leucoencefalopatía multifocal progresiva (LMP), infección oportunista fatal causada por la reactivación del virus latente John Cunningham (JC), en pacientes con EC y esclerosis múltiple (EM) tratados con natalizumab 19,20 .…”

From historical perspectives to modern therapy: a review of current and future biological treatments for Crohn’s disease

“…Juillerat and colleagues noted a 46% clinical response (HBI decrease ⩾3 points) and a 56% cumulative probability of achieving remission (HBI < 4) within one year [Juillerat et al 2013]. Other efficacy studies have examined a clinical response as defined above, the ability to decrease steroid requirements and mucosal healing [Kane et al 2012;Sakuraba et al 2013a].…”