Experiencia local con natalizumab en pacientes con enfermedad de Crohn refractaria a anti-TNF: Casos clínicos
Anti-tumor necrosis factor-α (TNF) agents have dramatically changed the management of Crohns 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...
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| Lenguaje: | Spanish / Castilian |
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Sociedad Médica de Santiago
2017
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oai:scielo:S0034-988720170004000152017-07-18Experiencia local con natalizumab en pacientes con enfermedad de Crohn refractaria a anti-TNF: Casos clínicosFluxá,DanielaIbáñez,PatricioFlores,LilianFigueroa,CarolinaLubascher,JaimeKronberg,UdoSimian,DanielaPizarro,GonzaloToche,PaolaQuera,Rodrigo Biological Therapy Crohn Disease Inflammatory Bowel Disease Natalizumab Anti-tumor necrosis factor-α (TNF) agents have dramatically changed the management of Crohns 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 patients 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 Crohns disease refractory to treatment with infliximab, who responded successfully to the use of Natalizumab.info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.145 n.4 20172017-04-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872017000400015es10.4067/S0034-98872017000400015 |
| institution |
Scielo Chile |
| collection |
Scielo Chile |
| language |
Spanish / Castilian |
| topic |
Biological Therapy Crohn Disease Inflammatory Bowel Disease Natalizumab |
| spellingShingle |
Biological Therapy Crohn Disease Inflammatory Bowel Disease Natalizumab Fluxá,Daniela Ibáñez,Patricio Flores,Lilian Figueroa,Carolina Lubascher,Jaime Kronberg,Udo Simian,Daniela Pizarro,Gonzalo Toche,Paola Quera,Rodrigo Experiencia local con natalizumab en pacientes con enfermedad de Crohn refractaria a anti-TNF: Casos clínicos |
| description |
Anti-tumor necrosis factor-α (TNF) agents have dramatically changed the management of Crohns 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 patients 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 Crohns disease refractory to treatment with infliximab, who responded successfully to the use of Natalizumab. |
| author |
Fluxá,Daniela Ibáñez,Patricio Flores,Lilian Figueroa,Carolina Lubascher,Jaime Kronberg,Udo Simian,Daniela Pizarro,Gonzalo Toche,Paola Quera,Rodrigo |
| author_facet |
Fluxá,Daniela Ibáñez,Patricio Flores,Lilian Figueroa,Carolina Lubascher,Jaime Kronberg,Udo Simian,Daniela Pizarro,Gonzalo Toche,Paola Quera,Rodrigo |
| author_sort |
Fluxá,Daniela |
| title |
Experiencia local con natalizumab en pacientes con enfermedad de Crohn refractaria a anti-TNF: Casos clínicos |
| title_short |
Experiencia local con natalizumab en pacientes con enfermedad de Crohn refractaria a anti-TNF: Casos clínicos |
| title_full |
Experiencia local con natalizumab en pacientes con enfermedad de Crohn refractaria a anti-TNF: Casos clínicos |
| title_fullStr |
Experiencia local con natalizumab en pacientes con enfermedad de Crohn refractaria a anti-TNF: Casos clínicos |
| title_full_unstemmed |
Experiencia local con natalizumab en pacientes con enfermedad de Crohn refractaria a anti-TNF: Casos clínicos |
| title_sort |
experiencia local con natalizumab en pacientes con enfermedad de crohn refractaria a anti-tnf: casos clínicos |
| publisher |
Sociedad Médica de Santiago |
| publishDate |
2017 |
| url |
http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872017000400015 |
| work_keys_str_mv |
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| _version_ |
1718436941152649216 |