Mo1833 Clinical Characteristics of Crohn's Disease and Ulcerative Colitis Patients Who Switched From an anti-TNF-α Agent or Natalizumab to Vedolizumab or an Alternative anti-TNF-α (original) (raw)
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Gastroenterología y Hepatología, 2011
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Revista médica de Chile
Natalizumab for the treatment of Crohn's disease. Report of three cases 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.
Gastroenterología y Hepatología, 2019
Enfermedad inflamatoria intestinal; Antifactor de necrosis tumoral; Infliximab; Adalimumab; Suspensión de tratamiento Resumen La efectividad de la terapia con fármacos antifactor de necrosis tumoral ␣ en la enfermedad inflamatoria intestinal ha sido probada en la práctica clínica. Tras más de una década de uso de este tipo de fármacos, surge la interrogante acerca de si existe un momento apropiado para suspender estas terapias, y de qué manera esta debiera realizarse. Esta revisión tiene por objetivo evaluar la evidencia actual acerca del retiro de la terapia con antifactor de necrosis tumoral ␣ y, eventualmente, identificar las condiciones o los subgrupos de pacientes potencialmente candidatos a la suspensión o el retiro de esta.
[Acute severe ulcerative colitis treated with accelerated infliximab induction. Case report]
Revista medica de Chile, 2017
Acute severe ulcerative colitis (ASUC) is a potentially life-threatening condition that requires early recognition, hospitalization and adequate treatment. Currently, the use of infliximab in ulcerative colitis (UC) is recommended in the case of severe disease refractory to corticosteroids, once that superimposed bacterial or viral infections (such as cytomegalovirus or Clostridium difficile) have been excluded. However, conventional weight-based regimens of infliximab might be insufficient for patients with ASUC. Accelerated infliximab induction regimen may increase its serum concentration levels and efficacy by reducing early colectomy rates in these patients. We report a 34 year old female presenting with an ASUC. She was initially treated with hydrocortisone 300 mg/day and mesalazine enemas 4 g/day with an unfavorable clinical response. At the fifth day of therapy, an accelerated induction therapy with infliximab was started in doses of 10 mg/kg at weeks 0, 1 and 4. After the se...