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

BACKGROUND: Despite trials demonstrating its efficacy, many physicians harbor concerns regarding the use of natalizumab in the treatment of patients with refractory Crohn's disease (CD). The purpose of this study was to perform a descriptive analysis of a series of CD patients not currently enrolled in a clinical trial. METHODS: A retrospective case review of patients treated with natalizumab at 6 sites in Massachusetts: Boston Medical Center, Beth Israel Deaconess Medical Center, Brigham & Women's Hospital, Lahey Clinic, Massachusetts General Hospital, and UMass Medical Center. RESULTS: Data on 69 CD patients on natalizumab were collected. At the start of treatment, patients' disease duration was 12 years. A high proportion of patients were women (68%), presented with perianal disease (65%) and upper gastrointestinal tract involvement (14%). Prior nonbiologic therapies were steroids (96%), thiopurines (94%), antibiotics (74%), methotrexate (58%), and at least two anti-tumor necrosis factor agent failures (81%). Sixty-nine percent (44 of 64 patients) with available medical evaluation had a partial or complete clinical response. Loss of response was 13% after an average of 1 year of treatment. Adverse events were infusion reactions, headaches, fever, and infections. No case of progressive multifocal leukoencephalopathy was observed. CONCLUSIONS: 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.

Kritische Beleuchtung der in den Jahren 1831 und 1832 in Deutschland vorgekommenen ständischen Verhandelungen über die Emancipation der Juden

von Gabriel Riesser

Recht, Glaube und Wahrheit, oder auch ein Wort für die Emancipation der Juden

von L. Lischka

Beitrag zur Emancipation der Juden : ein Wort an deutsche Ständeversammlungen

von Eduard Reis

Jüdische Absonderung! : Erwägung einiger Bedenken gegen die "Emancipation der Juden"

von Isaac B. Lowositz

Abwehr der bei den Verhandlungen der hohen Kammer der Abgeordneten über die Emancipation der Israeliten in Bayern von einigen Mitgliedern derselben erhobenen Anschuldigungen gegen das Judenthum und den Talmud

von H. Schwarz

Ben-Lee, oder: ist eine Emancipation der Juden denkbar? : Biographische Skizze aus dem Tagebuche eines Poeten

von F. Th. Wangenheim

Betrachtungen über die Verhandlungen der 2ten Kammer des Grossherzogthums Baden über die Emancipation der Juden

[Gabriel Riesser]