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Published on: October 27, 2014
Natalizumab (Tysabri) treatment for relapsing multiple sclerosis
1Department of Neurology, University of Maryland Baltimore School of Medicine, Maryland Center for Multiple Sclerosis, Baltimore, Maryland 21201, USA. kjohnson@som.umaryland.edu
The Neurologist
|July 12, 2007
Summary
Natalizumab effectively treats relapsing multiple sclerosis (MS) by reducing inflammation. However, safety concerns have led to restricted use, necessitating careful patient selection for this MS therapy.
Area of Science:
- Neuroimmunology
- Pharmacology
Background:
- Natalizumab is a humanized monoclonal antibody targeting alpha4beta1 integrins on leukocytes.
- It inhibits leukocyte attachment to cerebral endothelial cells, reducing blood-brain barrier inflammation in multiple sclerosis (MS).
Observation:
- Two trials showed natalizumab's efficacy in controlling relapsing MS, reducing disability, and decreasing new MRI lesions.
- Safety concerns, including progressive multifocal leukoencephalopathy (PML), have restricted its use.
Findings:
- Natalizumab is approved for relapsing MS, alongside glatiramer acetate and interferon beta.
- Its use is currently limited to monotherapy for patients with inadequate responses to other immunomodulators.
Implications:
- Understanding natalizumab's mechanism and PML pathogenesis is crucial for safe MS treatment.
- Therapists must carefully consider risks and benefits when prescribing natalizumab for multiple sclerosis.
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