What is the role of natalizumab in the treatment of inflammatory bowel disease (IBD)?

Updated: Apr 10, 2020
  • Author: William A Rowe, MD; Chief Editor: BS Anand, MD  more...
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Natalizumab (Tysabri), an agent aimed at preventing the accumulation of lymphocytes in the diseased bowel by blocking the effects of both α4β7 integrin (gut specific) and α4β1 integrin (CNS specific), has been approved by the FDA, but it is only available through a restricted distribution program. Natalizumab is an intravenous medication that has shown efficacy in Crohn disease, but there have been three reports of progressive multifocal leukoencephalopathy, a potentially fatal opportunistic viral infection. Risk is typically apparent in those with prior immunosuppressant exposure or with a duration of infusion for longer than 2 years. [102] Patients in whom this agent is used should first be tested for John Cunningham (JC) virus, and they should be periodically tested for this during treatment.

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